Get Outpatient Ultrasound Request Form - Alpenglow Veterinary ...

Filling out the Outpatient Ultrasound Request Form at Alpenglow Veterinary is a straightforward process designed to ensure that your pet receives the necessary care. This guide provides step-by-step instructions to help you complete the form online with clarity and ease.

Follow the steps to complete the Outpatient Ultrasound Request Form effectively.

1. Press the ‘Get Form’ button to access the Outpatient Ultrasound Request Form and open it in your preferred document editor.
2. Enter the date of the request in the designated field.
3. Fill in the owner’s name as the primary contact for the ultrasound appointment.
4. Provide your pet’s name to ensure accurate identification.
5. Specify the breed of your pet in the corresponding section.
6. Indicate the age of your pet, providing the number of years or months.
7. Circulate the appropriate option to denote the sex of your pet and whether they are spayed or neutered.
8. Complete the clinician or referring doctor’s name (rDVM) to facilitate communication.
9. Input the practice name where the clinician works.
10. List a phone number where the rDVM can be reached after the examination and a fax number for receiving the report.
11. Select the type of ultrasound, circling either abdominal or thoracic as applicable.
12. Fill out the fax number for the report to be sent to, and specify any other relevant options.
13. Provide a detailed patient history in the space provided, including any relevant doctor's notes.
14. Document any abnormalities from recent bloodwork, along with providing supporting faxed documents.
15. Indicate whether radiographs were previously performed, and if so, whether they were sent with the owner.
16. Specify if a previous ultrasound was done and attach a copy of that report if applicable.
17. State if you are requesting a consult with an internal medicine specialist, noting their availability.
18. Answer whether you request a fine needle aspirate if abnormalities are detected, and include a contact number for follow-up.
19. Outline the sedation protocol as per your discretion and depending on your pet's needs.
20. Finalize the form by saving your changes, then choose to download, print, or share the completed form.

Complete the Outpatient Ultrasound Request Form online to ensure your pet receives timely care.