Referral Form

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Thank you for giving Veterinary Healing & Advanced Imaging the opportunity to partner with you for your patient’s diagnostic and treatment needs. Please complete this referral form.

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Services

CT
Abdominal Thorax Thoracic Wall Lungs Mediastinum Skull Nasal Cavity Bullae Orbit Spine Musculoskeletal Limbs Other
Cervical (C1-T3) Thoracolumbar (T4-S1) Other
Elbow Shoulder Stifle Hips/Pelvis Other
Right Forelimb Right Hindlimb Left Forelimb Left Hindlimb Other
PRP
Joint Tendon / Ligament Muscle Other
Hip(s) Elbow(s) Knee(s) Right Left Both Other
Yes No
HILT
Pain Management Wound Healing Other
Yes No
Orthopedic Surgery Soft Tissue Surgery
Titanium Steel Other
Arthritis Inflammation Acute Condition
Cervical Spine Thoracic/Lumbar Spine Hip(s) Elbow(s) Carpus/Tarsus Stifle(s) Chronic Kidney Disease Pancreatitis Stomatitis Other



Labwork Radiographs ECG Other medical records
The maximum file size is 5mb (jpg, jpeg, png, pdf, doc)

Veterinary Healing & Advanced Imaging, leading animal referral center in the Bay Area specializing in CT Scans & Imaging, MRIs, Laser Therapy, Hyperbaric Oxygen Therapy & Platelet Rich Plasma Therapy.

  • 1945 Contra Costa Blvd Suite B
    Pleasant Hill CA 94523
  • (925) 265.8385
  • info@veterinaryhealingandimaging.com

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