Please download and fill out the following form and fax it over to our office at 805-904-6772. After receiving your request form, one of our staff members will follow up with your office to confirm receipt and to introduce ourselves. If there are any urgent matters that require more immediate attention, please do not hesitate to call our office directly at 805-904-6771 or us the contact us page on our site to e-mail us.
** Please send any current pertinent blood work along with the request form. Copies of patient medical records are not necessary.Are there any radiographs associated with the current condition? Please make sure you provide us with this answer in the digital form to the left.
** If yes, please send these images via the Vetology platform to Dr. Jones as a “Non-Billable for Referral” request if you do not want a written interpretation report. If a written interpretation report is desired, please send the images as a standard interpretation request. If you do not use the platform, please send the images via email to firstname.lastname@example.org, or on a disc with the client if preferred. If you have already submitted the radiographs via the Vetology platform for a reported interpretation, please let us know.
Please include your preference for how you would like to receive the report (fax or email) along with the history. A written request can be downloaded below and can be faxed back to Central Vet Imaging at 805-904-6772, or emailed to email@example.com.