Tinton Falls Diagnostic Imaging Form


Referring Veterinarian Information

Hospital Address(Required)

Client Information

Client Name(Required)

Client Address(Required)

Patient Information

Patient Name(Required)



Type of Ultrasound*(Required)

Procedures Requested

Please inform the owner of the following:

Food should be withheld for 12-15 hours prior to the procedure for optimal image quality and in the case that sedation/anesthesia is required. If this is not possible for medical reasons, please contact us. Withholding water is not necessary.

For ultrasonographic procedures, the area of interest will be shaved to optimize image quality and maximize the diagnostic potential of the test.

Owners will not be given the results of the imaging procedures performed except under certain, critical circumstances. The owners will be asked to contact your office for imaging results, and to make plans for further actions. This is to keep you in control of your case and to simplify communications. Imaging turnaround time is roughly 24-48hrs.

If you wish to have another doctor at our facility go over the imaging results with the owner and make further recommendations, please speak to the imaging department to set up the appropriate consultation.

Biopsies and other interventional procedures are not scheduled as outpatient procedures and cannot be performed as an add-on to an outpatient exam except in critical cases where the case is transferred to a staff doctor for case management. Please call us for more information.