CT Request Form

We’re delighted you’ve chosen URvet Care Medical Center. Please provide as much detail as possible in the form below. If you have any questions, we’re just a call away at 646-221-1200.

Patient CT Request Form

Clients interested in scheduling a CT should complete the following form. Someone from our team will follow up with UR referring veterinarian for UR pets medical records.

Our Cat Scan is located at our URvet Care Medical Center in Midtown.
252 E 57TH STREET, MANHATTAN, NY 10022

Pet Owner Name

Pet Owner Email

Pet Owner Phone Number

Pet Name

Breed

Species

Age

Brief history - why are you looking for a CT?

Veterinary Clinic

Name of veterinarian

Veterinary Office Email

Veterinary Office Phone

look forward to vet visits

CT Request Form

Patient CT Request Form

Better Care, When You Need It

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URvet Care Medical Center - Roslyn