Submit Radiology Consult Request Form Online Here.   Enter Hospital Name:  * required Veterinarian Requesting Consultation:  * required Email (optional): Enter Pet name followed by Owner last Name: (Format example: Rex Smith)  * required Pet ID number (optional): Breed:  * required Pet's sex/Neuter status: (click to highlight appropriate selection below) Spayed Female Neutered Male Intact Female Intact Male Unknown sex or neuter status Cryptorchid male Pet's Age:  * required History (pertinent laboratory, historical and physical exam findings): Current Medications? 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.   * required   Indicate the date of the diagnostic imaging exam(s) you are submitting. (Month-day-year format: example 8-7-16)    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.**
Click link below to download a blank history form for fax submission. The fax method is not recommended and will increase the turn-around time for your consultation compared to submission via DVMinsight or other digital case submission methods. Submission of diagnostic images for consultation in DICOM format is recommended. Jpeg files have lower image quality and may be non-diagnostic. Contact us at (888) 788-RADS if you need instructions on how to upload/transmit files.   You can fax the completed form to (973) 833-0381 to submit a case for review, however we recommend you submit histories via the on-line form at the top of this page for the best service.   You can click here to email us at images.mvr@gmail.com Click here to download blank MVR history form.