205-235-8759
referral@vovcbham.com
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Orthopedic Radiograph Consultation
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Referring DVM
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Orthopedic Radiograph Consultation
This service comes at no charge.
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Please complete this form:
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Correspondence for radiograph consults will be emailed.
Date
*
Referring Veterinarian Name
*
First
Last
Practice Name
*
Requesting Veterinarian Email Address
*
Referring Veterinarian Telephone Number
*
Patient Name
*
Sex
*
Male
Male Neutered
Female
Female Spayed
Patient Species
*
Dog
Cat
Patient Weight
*
Patient Age
*
Patient History
*
Link to the radiographs (IDEXX, Antech, Heska, etc.)
DICOM Images
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Upload JPEGs
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