Veterinary Health Center at Kansas State University
Radiographic Referral Information

**Please note, this service will be discontinued on September 1, 2016**

Please be aware! The Veterinary Health Center has a turn-around time of 7-10 days on radiology consults.
The referral charge is $90.00 per case. Prepaying whenever possible by sending a check with the films is appreciated.

CLINIC & CLIENT INFORMATION

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RADIOGRAPHIC EXAMINATIONS:

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PATIENT HISTORY:



PHYSICAL EXAM FINDINGS:



SIGNIFICANT LABORATORY DATA:



SPECIFIC QUESTIONS YOU WOULD LIKE ANSWERED:



If you would like to manually fill out this document and fax it in, you can find a printable version here. Please fax to (785) 532-0881.