Insight Imaging & Diagnostics Scheduling
Michael Wasserman, DVM - Sonograms with Insight
Please complete all required fields. Appointment confirmations will be made by an e-mail or return phone call within 1-2 hours during normal business hours.
For same-day sonogram requests, call 862-228-1982 first for availability. Then, submit this history form.
Please select your preferred sonogram date below. Available dates shown on the calendar are currently open for booking. A scheduled arrival time will be provided by email once the request has been reviewed and confirmed. If any scheduling changes occur, Insight will contact you by phone or text.
*
-
Month
-
Day
Year
What sonogram request is this?
*
Please Select
Abdominal Ultrasound
Echocardiogram (DACVIM Interpret.)
Bicavitary Sonogram
Abd. US w. Small Parts Add-on
Echocardiogram w. Small Parts Add-on
Pre-Anesthetic Echo Add-on
Please select a drop down
For bi-cavitary studies, do you require a DACVIM Cardiologist interpretation? (Only answer for bi-cavitary sonogram.)
Yes
No (DABVP small animal medicine specialist will interpret)
Hospital Name and Requesting Doctor (Last Name)
*
Patient Information
*
First Name
Last Name
Age
*
Species
*
Breed
*
Sex
*
Weight (lbs)
*
Is sedation approved by the client if needed? A relaxed abdomen improves image quality, penetration, and efficiency. Sedation recommendations available upon request. For routine canine abdominal ultrasound (low anxiety, no cardiac disease): low-dose dexmedetomidine (2-5ug/kg) + butorphanol (0.2-0.3mg/kg) IV provides reliable, reversible relaxation with minimal complications.
*
Yes
No
Please provide a relevant clinical history, recent bloodwork and testing, including current medications and any information pertinent to the primary reason for this sonogram. Please note that all sonograms are submitted to specialists for interpretation and recommendations.
*
0/1600
Notes, comments, or background for case interpretation (This will NOT be included on the report.)
Attach any clinically relevant supplemental information, radiographs, rad report, ecg, etc. If documents need to be submitted after this request (the day of the ultrasound), please email me directly supporting clinical information at mwasserman@insightdvm.com with attachments.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: