Board Certified Radiologist


Radiographic Consultation

When referring a patient for a radiological consultation, please fill out the following form in full.  If you would prefer to fill out the form by hand, please Download the Radiology Consultation Form and return to FVRC by fax: 239.992.0884. If radiographs are digital, please email to

» Download / Print Radiological Consultation Form

  • Referring Veterinarian

  • Client Information

  • Patient Information

  • History