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Patient History Form – Abdominal

 

    Referring Doctor


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    **Please note additional fee applies for thoracic cavity interpretation on an abdominal ultrasound**

    If you anticipate your patient needing fine needle aspirates, please obtain consent prior to scan, as well as permission to sedate if needed.

    When you submit this form, you will be emailed a copy of the information you submitted. You can print that email for your records.