Online Form

Radiology Consultation Form

Consult fees apply. For current rates (verbal consult and written consult), please call us at 919-545-1001.

For radiograph consultations to be completed by our surgeons, please ensure you have included the following information along with the images for review:

Referring Veterinarian

Clinic Name(Required)

Best Clinic Email to Respond(Required)

Doctor Requesting the Consultation *(Required)

First Last

Client

Client Name(Required)

First Last

Patient Name(Required)

Patient Signalment(Required)

Patient History & Supporting Information (Please include with this referral copies of any diagnostics, including lab work, radiographs, ultrasound, etc.)

File Upload - Diagnostics, Lab Work, Radiographs, Ultrasound

Max. file size: 50 MB.

Verbal or Written Consultation Being Requested:(Required)

Please note that Verbal Radiograph Consultations are $65 and Written are $125. Please ask the client to call for an appointment. 919-545-1001. Our hours of operation are Monday-Friday 7:30 a.m. to 5:30 p.m. Thank you for your referral.

Name

This field is for validation purposes and should be left unchanged.

Online Form

Radiology Consultation Form