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Advanced Veterinary Imaging Direct

Online Imaging Request

UofM VMC Staff

For My Client

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For the rDVM

CT Scan
MRI
Should I choose MRI or CT
Special Procedures
Ultrasound
Consultation with Radiologist
Preparation for General Anesthesia
Printable Imaging Request Forms (pdf)

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  Home > Advanced Veterinary Imaging Direct > Online Imaging Request

Advanced Veterinary Imaging Direct

Outpatient Diagnostic Imaging
  ( Require browser JavaScript enable, check here ) ( * ) input required  
Referring DVM Information Client/Patient Information
  Hospital Name * :
    		  Client's Name * :
   
  Referring DVM (rDVM) Name * :
    		  Telephone Number * :
   
  Telephone Number * :
    		  Email Address :
   
  Best Time to Call :
    		  Pet's Name * :
   
  Fax Number * :
   
  Age or DOB * :
    		  Breed * :
   
  Email Address :
   
  Weight * :
    		  Weight Unit * :
        
  Prefer printable request forms (pdf)?   Sex * :
             
   
Please select a procedure from below *
For more than one procedure request, please fill out and submit each procedure separately.
CT Scan ( requires general anesthesia )
   
MRI ( requires general anesthesia )  
Special Procedures ( some procedures may require sedation or general anesthesia )
{ Cystourethrography, Dynamic Esophagography, Fluoroscopy of the respiratory tract, Intravenous Urography (IVU), Upper Gastrointestinal (GI) Series }		  
Ultrasound ( some procedures may require sedation )  
 
 
Consultation with Radiologist ( If you have questions regarding which procedure should be selected for the desired information, please ask for a consultation with our radiologists )  
   
 
 
Questions? Contact AVID staff at (612) 624-9583
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