SAIM Consultation

Invalid Fields

There are 0 invalid fields. They have been highlighted.

Instructions

This service is for veterinarians only.

If you are not a veterinarian and are seeking medical advice on behalf of your personal pet or animal, please contact your primary care veterinarian for guidance. If this is a medical emergency, please call the U of I Small Animal Clinic at (217) 333-5300.

If you are a veterinarian and wish to initiate a consult request to the Small Animal Internal Medicine Service, please answer the following questions below. File uploads are optional. Please note that this is for a consultation request only and not a referral request. Please make sure to include the reason or specific clinical questions for your consultation. For additional guidance on the Small Animal Internal Medicine Service and how to refer a patient, see this link:

https://vetmed.illinois.edu/4dvms

Conditions

Please answer the following questions to submit a consult to the Small Animal Internal Medicine service.

All questions with an * are required for proper submission and must be completed.

We will do our best to address all consultation requests in a timely manner based on current in-hospital caseload. Generally this is within 1-2 business days from the time of submission.

Consultations will be returned M – F from 10 am – 5 pm. Consultation requests submitted after 5 pm or on weekends/holidays will not be viewed until the next business day.

The veterinarian submitting the request will be contacted by either telephone or email as determined by the consultant. Please provide a direct phone number at which we can easily reach you and/or inform your receptionist of the impending call. Based on our busy clinics schedule, we cannot call you at a guaranteed or specified time.

The Small Animal Internal Medicine (SAIM) service provides consultations to veterinarians at no cost. In order to provide the best possible advice, please provide a concise case summary (below) with attention to the case timeline and progression, any pertinent diagnostic results, implemented treatments, and treatment responses. If you wish, you may also upload laboratory data by use of the link below. We will not review multi-page, full medical records – all pertinent case information should be in the summary.

I understand and agree to these conditions.*

Veterinarian Contact Information

First Name*

Last Name*

Clinic Name*

Direct Phone Number*

Email Address*

Hospital Fax Number

Patient Information

Pet's Name*

Date of Birth (mm/dd/yyyy) or Age*

Breed*

Weight (kg.)*

Sex*

M - Male

F - Female

FS - Female spayed

MC - Male castrated

Other Pertinent Information for Signalment

Patient History

Has the patient been seen at the University of Illinois VTH in the recent past?*

Yes

Please provide the UIUC Medical Record #

Please provide a concise medical history with attention to the case timeline and progression.*

Please describe any concurrent or relevant previous medical conditions.*

enter ‘none’ or ‘n/a ‘, if not applicable

Please list all current medications (prescription or OTC) and supplements:*

enter ‘none’ or ‘n/a‘ if patient is not receiving any treatments

What is the reason for your consult request? What specific questions do you have?*

Bloodwork/ Laboratory data upload #1: (optional)

Supported document file types: docx, pdf

Bloodwork/ Laboratory data upload #2: (optional)

Supported document filed types: .docx, pdf

Bloodwork/ Laboratory data upload #3: (optional)

Supported document filed types: .docx, pdf

Submit

When ready to submit, check the box below to confirm that all information has been entered. Please remember that all information with an * are needed to proceed.

If this is an urgent matter or an emergency situation, please contact the Small Animal Emergency/Critical Care service at (217) 333-5300 or your local emergency service.

If you are having difficulty attaching files or submitting a consult, please call (217) 333-5311 to talk to our referral coordinator.

Ready to submit*

Invalid Fields

There are 0 invalid fields. They have been highlighted.