Radiology Referral Form

If you are a veterinarian who would like to refer a patient to the Radiology Department at Veterinary Specialty Center of Tucson, please complete our referral form.

Records are required in advance of all imaging referrals.
Referral ultrasounds are by morning drop off Monday - Friday between 7:00 am - 8:30 am.
Referral CT scans are by appointment.

Today’s Date

Client / Owner’s Name

Client / Owner’s Phone

Patient Name

Referring Clinic

Referring Clinic Email Address

Referring Clinic Phone

Veterinarian Name

Reason For Referral

Records Required*Lab work, radiographs, current medications. If you are uploading multiple files, please upload them as a Zip file.

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This referral is for diagnostic imaging only. All imaging to be sent to referring clinic for medical management unless an emergent or life-threatening condition is detected.

This referral is for diagnostic imaging AND treatment recommendations by ER doctor team based on findings.

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Radiology Referral Form

Records are required in advance of all imaging referrals.Referral ultrasounds are by morning drop off Monday - Friday between 7:00 am - 8:30 am.Referral CT scans are by appointment.

Emergency Care 7 Days a Week

Records are required in advance of all imaging referrals.
Referral ultrasounds are by morning drop off Monday - Friday between 7:00 am - 8:30 am.
Referral CT scans are by appointment.