Get the free PET Myocardial Perfusion Referral Form and Related Information.pdf - biomedpet

REFERRAL INSTRUCTIONS The following information is needed in order to schedule a PET scan: 1. PET Myocardial Perfusion Imaging Referral Data Sheet (attached×. This form must be completed and signed

How to fill out pet myocardial perfusion referral

How to fill out a pet myocardial perfusion referral:

1. Begin by collecting all the necessary information about the patient. This includes the pet's name, age, breed, and any relevant medical history.
2. Specify the reason for the referral. In this case, it would be for a pet myocardial perfusion procedure.
3. Provide a brief summary of the patient's current health condition, including any symptoms or pre-existing heart conditions.
4. Indicate any previous diagnostic tests or treatments that have been performed on the pet, especially those related to the cardiovascular system.
5. Explain the rationale for requesting a pet myocardial perfusion procedure. This may include suspected heart disease, abnormal cardiac findings, or the need for further evaluation of a previously detected issue.
6. Include any specific instructions or requests for the perfusion test, such as additional imaging or specific protocols that should be followed.
7. Mention any recent changes in the patient's medication or dietary regimen that could affect the procedure or its interpretation.
8. Provide the contact information of the referring veterinarian, including their name, clinic name, address, and phone number.

Who needs a pet myocardial perfusion referral?

1. Pets with suspected heart disease: If a veterinarian suspects that a pet may have heart disease based on clinical signs or physical examination findings, they may refer the pet for a myocardial perfusion procedure to obtain more detailed information about the heart's blood supply.
2. Pets with abnormal cardiac findings: If an echocardiogram or other cardiac diagnostic test reveals abnormal findings, a pet myocardial perfusion referral may be necessary to assess the blood flow and determine the extent of any cardiac perfusion abnormalities.
3. Pets requiring further evaluation: In cases where a previous test or treatment has raised concerns or provided incomplete information about a pet's cardiovascular health, a myocardial perfusion referral can help to identify any underlying issues and guide further treatment decisions.

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