Computed Tomography (CT) Referral Form

When requesting an outpatient CT study, the requesting clinician will be solely responsible for communicating the results and making treatment recommendations based on the findings. Only referring veterinarians can request an outpatient CT.

Please complete the form below and upload or email the patients most recent pertinent medical records, lab work and radiographs when applicable to avonanimal@gmail.com. After review of the submitted information, a technician will be in contact with the pet owner for scheduling. Please include the owners contact information in the referral form. Outpatient CT patients need to be fasted 12 hours ahead of their scheduled procedure and should be expected to be at the hospital for the morning of their procedure. Pets will be undergoing anesthesia and owners should expect a shaved area to facilitate the placement of an Intravenous catheter. CT patients require current bloodwork including a complete CBC and Chemisty profile.