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Cone Beam Computed Tomography Referral Request Form

We offer advanced imaging of the skull, cervical spine, tail, and distal limbs via cone beam computed tomography.

Accepting patients big and small – email us at info@albertavetdentistry.com for inquiries about the species we see!

When you refer a patient for Cone Beam Computed Tomography it starts with a quick phone consultation with one of our Registered Veterinary Technologists. These consultations are scheduled on a flexible basis at the convenience of your client. Your patient will be admitted to our clinic by a Registered Veterinary Technologist on the morning of their scan. One of our doctors will perform a physical examination and your patient will be sedated or anesthetized under the direct supervision of Dr. Jessica Pang. Tomographic imaging of the selected anatomic site (with or without contrast) will be collected and submitted for interpretation by a veterinary radiologist. Your patient will be safely recovered and routinely discharged. The radiologist interpretation and access to the CBCT images will be provided to you within 5 business days. The referring veterinarian is responsible for reporting the diagnostic results and providing treatment recommendations to the client and patient.


‌If the referring veterinarian is unsure of whether or not their patient might need contrast, it is best to refer the patient for a consultation with one of our doctors rather than requesting an out-patient CBCT.

Date
Month
Day
Year

Owner's Address

Multi-line address
Sex
Male
Female
Spayed
Neutered
Pet Insurance
Trupanion
Petsecure
Fetch (PetPlan)
Pets + Us
Unknown
None
Other
With the concern(s) listed above, do you require administration of contrast?
Yes
No
Current and/or previous systemic issues, please check all that apply:
Diagnostics that have been completed within the last year, please check all that apply (if an echocardiogram has EVER been done please also include these results):
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CONTACT US

Suite #107 358 - 58th Avenue SW

Calgary, AB, T2H 2M5

Comprehensive Dentistry.
Advanced Anesthesia.
Collaborative Communication.
Professional Development.
CLINIC HOURS

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

8:00am - 5:00pm

8:00am - 5:00pm

8:00am - 5:00pm

8:00am - 5:00pm

CLOSED

CLOSED

CLOSED

HOLIDAYS CLOSED
*Surgical admission and discharge may be scheduled outside of normal business hours
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