Get Radiology Referral Form - Massey University - Massey Ac

Filling out the Radiology Referral Form is an essential step in facilitating appropriate diagnostic imaging for your client’s animal. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to successfully fill out the Radiology Referral Form online.

1. Press the ‘Get Form’ button to access the Radiology Referral Form and open it for editing.
2. Indicate whether the referral is urgent or non-urgent by selecting the appropriate checkbox.
3. Provide the date on which you are filling out the form in the designated space.
4. Fill in the referring veterinarian's name, practice, and contact details, including phone, fax, and email. Ensure to select your preferred method of contact.
5. In the section designated for availability, indicate when you can be reached in the next 24 hours.
6. Enter the client’s name and their contact address accurately to ensure proper communication.
7. Document the animal’s name, species, breed, sex, and age. Additionally, indicate if the animal is neutered by selecting 'Yes' or 'No.'
8. Detail the pertinent clinical history, being as comprehensive as possible to provide the radiologists with relevant information.
9. Outline the current clinical differentials related to the case. This information is crucial for the assessment.
10. Specify the region to be examined and the modality of imaging required. Include the date of the study and the number of images.
11. Once all required fields have been completed, review the entire form for accuracy before proceeding.
12. Save your changes, and you may choose to download, print, or share the completed form as needed.

Start completing your documents online today for a seamless submission process.