Ultrasound Drop Off Form Your pet will be getting an ultrasound study today, done by a board certified Radiologist. Their schedule can be quite variable, as emergencies can arise, causing them to have to alter their planned route and schedule to handle this emergency. As a result, they request that your pet be dropped off in the morning here, so your pet can be available when they come. They also request that you not be present at the time of the exam. Any questions that you may have will be answered by our Doctors. This allows the Radiologist to be most efficient with their time so that they may be able to help and serve as many Patients and Clients as possible. Thank you for your cooperation!You should drop your pet off before 8:30am. Your pet should be fasted from the previous evening, unless instructed otherwise. Water through the night is generally ok-we will inform you if water through the night should not be available.Fees are $475 for one body cavity ( either abdomen or chest) and $635 for both cavities plus a Hospital Fee of $15-$40. Fine needle aspirates add another $130-$160, and Biopsies run about $220-$260. Lab fees are additional. Some pets need anesthesia or sedation in order to perform the study ( the patient needs to be quite still in order to get accurate, diagnostic images) and/or to get aspirates or biopsies. This can add an additional $75-$200, depending on what needs to be done.Name*Phone*Email* Please read the following and select accordinglyI give permission to do a fine needle aspirate and/or biopsy, if my Doctor feels it is necessary at the time of the ultrasound study. I understand and agree to the additional fees, as explained above.Please give me a call after the study, but before performing a fine needle aspirate or biopsy. I will be available at the following telephone number(s)Phone NumberIf I am not available to talk at that time, I understand that nothing additional will be done, and that I may have to bring my pet back another day if it is determined that an aspirate or biopsy is needed. I understand that there will be another hospitalization fee, in addition to the aspirate and/or biopsy fee, the lab fee, and possibly another, reduced, ultrasound fee.I give permission to sedate or anesthetize my pet if the Doctor feels it is necessary to safely do the ultrasound and/or the aspirate and/or the biopsy. I understand that without this authorization, the ultrasound, aspirate, or biopsy may not be done if the safety of the pet or the staff is at risk.YesNoName First Last Date Date Format: MM slash DD slash YYYY SignatureCommentsThis field is for validation purposes and should be left unchanged.