Outpatient Ultrasound Referral Form

Outpatient Ultrasound Referral

This form must be completed and submitted by the referring veterinarian before your client calls to schedule an appointment.

The health and safety of the patient is our primary concern. If we have any questions, a member of our team will be in touch.
Please Acknowledge the Following:*
- I understand no aspirates or biopsies will be performed during the outpatient ultrasound.
Client Communications*
- I understand as the referring veterinarian, I will be relaying the ultrasound findings and recommendations to the client.
Patient Temperament*
- I understand that outpatient ultrasound is offered for patients that are readily manageable without excessive restraint or sedation. Based on my experience with this patient, I believe this patient meets this criterion.

Outpatient Ultrasound Referral