For outpatient imaging, ARC clinicians perform the requested study without a consultation and the referring vet is responsible for reporting results.

Sedation is often required for abdominal ultrasound and general anaesthesia is always used for outpatient CT scans. Risks of sedation or anaesthesia should be discussed with the client prior to referral for outpatient imaging.

Results will be sent to the referring vet within 24 hours (ultrasound) and 48 hours (CT).

If a consultation is required, if additional procedures are desired or if the patient is unstable, then please refer for a standard consultation using the referral form for surgery, internal medicine or after hours care. Workup will then be performed by the receiving clinician after consultation with the client.

Please also use this form for requests for X-ray reporting by Dr Angela Hartman.

If you have an case that needs to be seen urgently please call the practice on 09 281 5815.

Are you a machine? If not please enter nothing in here:

Referring Vet Details
Veterinary Clinic Name:*
Referring Vet Name:*
Vet Email:*

CLIENT DETAILS
Surname:*
First name:*
Address:*
Postcode:*
Home phone number:
Mobile phone number:*
Email:

Patient Details
Name:*
Species:*
Breed:*
Date of Birth:
Gender:*
Brief Overview of Presenting Complaint:

SERVICE SELECTED
  Ultrasound - Abdomen
  Possible need and associated risks of sedation have been discussed with the client.
Please perform fine needle aspiration (FNA) if clinically indicated*
  Echocardiogram
  Pregnancy ultrasound
Region:
  CT
  Risks of general anaesthesia and IV contrast administration have been discussed with the client.

An ARC clinician will call to discuss the case prior to booking.
  Radiograph Reporting (billed to referring practice)
  DICOM images have been uploaded to our Keystone Community system

Keystone Community submission instructions
Additional notes
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Patient History 2:
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Supporting documents 8:
Additional notes: