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Ultrasound Referral Form

Please note we will require records prior to scheduling with the exception of pregnancy scans. You can attach records at the bottom of this form or send via email to info@byronvetmn.com. Our staff will reach out within 1-2 business days to discuss next steps.

  • Date Format: MM slash DD slash YYYY
  • Please give us a brief medical history and reason(s) for seeking ultrasound services.
  • Please choose all that apply. Full echocardiograms are not yet available. Other information can be added in box below.
  • What else might be good for us to know about the pet Ex: Will the pet need sedation to stay relaxed for 30-40min to complete the scan? Known allergies?
  • How quickly would you like us to see the patient? There are no guarantees on timing and we do keep a cancelation list for those that would like a sooner appointment than we have available. Please note urgent appointments may be subject to an additional charge.
  • Please include primary doctor's name if known.
  • It's important that we have a copy of the patient's medical history and cannot schedule with out it. If you don't have records at the time of completing this form, please send to info@byronvetmn.com as soon as possible.
    Drop files here or