• CT Request Form

    * For Referring Veterinarians Only
  • Specifics of your request such as questions about positioning and scan time can be directed to the imaging veterinarian or the technologist on duty. We will do our best to accommodate your requests, but same-day scans may not be possible due to pre-existing case load.

    We will reach out to the client to schedule once we have received the request and all necessary medical records (blood work and/or chest radiographs).

    This form should be submitted at least 24 hours in advance of the date that you are requesting. All imaging requests require recent CBC/Chem blood work (within the last month). Incomplete packages (i.e. no blood work) will not be reviewed until all information is provided.

    • Medical Information 
    • Requesting Veterinarian Information 
    • Hospital Information 
    • Client Information 
    • Patient Information 
    • Upload Documents 
    • Browse Files
      Drag and drop files here
      Choose a file
      Cancelof
    •  
    • Should be Empty: