Submit Radiology Consult Request Form Online Here.
Veterinarian Requesting Consultation:
Enter Pet name followed by Owner last Name: (Format example: Rex
Pet ID number (optional):
Pet's sex/Neuter status: (click to highlight
appropriate selection below)
History (pertinent laboratory, historical and
physical exam findings):
Sed./Anesthesia used for study?
What type of images are you submitting for review? (check
off appropriate box or boxes)
Submitting radiographs for review
Submitting abdominal US images
Submitting an MRI Study
Submitting CT scan
Describe images you are submitting for interpretation (views/anatomical
areas imaged; for example - VD and lateral thoracic and craniocaudal and lateral stifle radiographs):
List the number of radiographs you are submitting. If submitting
CT or MRI study; list the number of series/pulse sequences. If submitting US images; list the number of static images or/and
the number of video loops.
Indicate the date of the diagnostic imaging exam(s)
you are submitting.
Choose one of the following to tell us how
are you sending your images, so we know where to locate the images you are submitting for review. (Call 888-788-7237
extension 2, if you need assistance transmitting images)
Transmitting DICOM files direct to MVRserver
Uploading DICOM files via FTP to MVR Goggin folder
Submitting DICOM files on CD or video via mail or courier
Emailing DICOM files attached to email (DICOM files are very large, consider one image per email)
Submitting jpeg images via email or CD (AVOID THIS METHOD-vital image information can be lost)
For a STAT request text 973-980-1407 that you have submitted a STAT request. Also type
"STAT" just before your hospital name at the top of this on line submission form. Additional charges
apply, and STAT exams are subject to availability.
**IF YOU REQUEST
A SPECIFIC RADIOLOGIST THAT MAY DELAY YOUR INTERPRETATION FOR UP TO SEVERAL DAYS DEPENDING ON THE SPECIFIC RADIOLOGIST'S SCHEDULE.**