We’ll help you see what matters most. Booking is Easy - Just 3 Simple StepsWhether you’re requesting an abdominal ultrasound or an echocardiogram, getting started is quick and hassle-free.Fill Out the Request FormTell us about your clinic, your patient, and their needs.We’ll Reach Out to ScheduleA member of our team will contact you shortly to confirm details and arrange a time that works best.Secure Your AppointmentComplete a quick deposit to finalize your reservation. That’s it! Urgency * Based on clinical need, please. Super STAT incurs an additional charge of $199 Non-Urgent ASAP (within 7 days; not available for cardio) STAT (within 48 hours; not available for cardio) Super STAT (within 12 hours; not available for cardio) Call/Text 573-219-1847 Service Desired Abdominal Ultrasound Echocardiogram Thoracic Ultrasound (non-cardiac) Cervical (neck) Ultrasound Follow-Up Exam Other REFERRING CLINIC INFORMATION Referring Doctor * Referring Clinic Name * Referring Clinic Email * Used for invoices and other communications Referring Clinic Phone * (###) ### #### Referring Clinic Address * Address 1 Address 2 City State/Province Zip/Postal Code Country PATIENT INFORMATION Employee Pet * Employee discounts apply when paired with a full-price non-employee scan. Employment verification may be requested. No, this is a client-owned pet. Yes, this is an employee-owned pet. Patient Name * First Name Last Name Patient Age Status * Male Intact Male Neutered Female Intact Female Spayed Species Dog Cat Patient Breed Patient Approximate Weight (kg) 1-5 kg 5-10 kg 10-20 kg 20-30 kg 30-40 kg > 40 kg CLINICAL INFORMATION Patient History * Briefly tell us why you are requesting an ultrasound. Any additional information? Please be brief. BEFORE WE ARRIVE AT YOUR CLINIC Sedation Discussion With Owner * Please confirm that you have, or will, discuss the possibility of, and risks associated with, sedation for this exam. Yes, I have or will discuss this with the owner prior to your arrival. Fine Needle Aspirate (FNA) Discussion With Owner * Please confirm that you have, or will, discuss and pre-approve if necessary, this procedure and any potential risks associated with it. Yes, I have or will discuss this with the owner and obtain pre-approval prior to your arrival. I understand that an adequate platelet count within the past 30 days, and/or a coagulation panel, is strongly recommended prior to any FNA or cystocentesis. Thank you!
