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.

Referral CT scans are by appointment, records required.
Referral ultrasounds are by morning drop off Monday - Friday between 7:00 am - 8:30 am. Records are required.

Today’s Date

Client / Owner’s Name

Patient Name

Referring Clinic

Referring Clinic Email Address

Phone

Veterinarian Name

Reason For Referral

Please upload any records: lab work, radiographs, current medications.

Browse...

Please select one:

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.

Spam Blocker

Radiology Referral Form

Referral CT scans are by appointment, records required. Referral ultrasounds are by morning drop off Monday - Friday between 7:00 am - 8:30 am. Records are required.

Emergency Care 7 Days a Week

Referral CT scans are by appointment, records required.
Referral ultrasounds are by morning drop off Monday - Friday between 7:00 am - 8:30 am. Records are required.