College of Veterinary Medicine

Veterinary Teaching Hospital

Cardiology Consultation

This is NOT an Online-submitable form. You may print this form and hand write the contents or you may type your responses and then print the completed form.

Please indicate how you would like to be contacted (i.e., fax, phone, email) and list contact information.

Date of Examination  
Patient Name  

Pertinent History/ Laboratory Abnormalities:

Physical exam findings, i.e., jugular pulses, heart rate, murmurs (timing and point of maximum intensity), respiratory abnormalities (i.e., rate, noise, effort-inspiratory, expiratory)

Current Medications and Doses:

Please indicate interpretation/s requested:

ECG  ($64)
Thoracic Radiography ($64)
Echocardiography (digital video files preferred) ($76)
ECG, Thoracic Radiography and Echocardiography ($204)

 Other  Specify 

When submitting a FAX or a consultation on a critical case, please contact the Cardiology Service at 509.335.0711 or and inform the clinician that the materials are coming.

Thank you for your referral,

Lynne Nelson, DVM, MS
Diplomate ACVIM (Internal Medicine and Cardiology)
Sunshine Lahmers, DVM
Raychel Fairchild, RVT
Cardiology Technician

Last Edited: Jul 06, 2011 9:29 AM   

Veterinary Teaching Hospital PO Box 647060 , Washington State University, Pullman WA 99164-7060, 509-335-0711, Contact Us Safety Links