Get Ch2 Veterinary Imaging Consultants Veterinary Ultrasound Request Form

Filling out the CH2 Veterinary Imaging Consultants Veterinary Ultrasound Request Form online is a straightforward process that helps facilitate the ultrasound examination of pets. This guide will provide you with a clear, step-by-step approach to ensure the form is completed accurately and efficiently.

Follow the steps to accurately complete the form.

1. Press the ‘Get Form’ button to access the document and open it in your preferred online editor.
2. Begin by filling in the referring veterinarian's name in the designated field to ensure proper communication.
3. Next, enter the owner's name, as this will be used for official correspondence regarding the ultrasound.
4. Provide the clinic name to facilitate the correct routing of the request.
5. Fill in the pet’s name, which is important for accurate identification within veterinary records.
6. Include a contact phone number so that the clinic can reach the owner as needed for follow-up.
7. Enter the pet's age, sex, and species in the corresponding fields to assist in the ultrasound evaluation.
8. Provide an email address for further communications about the procedure.
9. Indicate the pet's breed and weight to give the veterinarian relevant information for the ultrasound.
10. In the checkboxes provided, mark all applicable procedures such as cardiac ultrasound, EKG, and abdominal ultrasound interpretation.
11. Fill in the history section to provide context regarding the pet's health and any previous medical interventions.
12. Include any bloodwork information that might be pertinent to the ultrasound examination.
13. Specify whether a cardiologist or radiologist interpretation is needed by marking ‘YES’ or ‘NO’ as appropriate.
14. If necessary, outline any specific organ systems of concern in the designated area.
15. Finally, enter the date at the bottom of the form to timestamp the request.
16. Review the form for accuracy, then save the changes, and proceed to download, print, or share the completed document as required.

Complete your veterinary ultrasound request form online with confidence.