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207-878-3121
    ABOUT
    EMERGENCY CARE
    OverviewEmergency SurgeryMedical EmergenciesToxins/PoisonsTrauma
    SPECIALTY CARE
    OverviewCardiologyDermatologyInternal MedicineDiabetes in CaninesDiabetes in FelinesFreestyle Libre Glucose MonitoringNeurologyOncologyOphthalmologyRadioactive Iodine Therapy for Hyperthyroid CatsRadiology + ImagingRehabilitation & Regenerative MedicineSynovetin OASurgery
    WHAT TO EXPECT
    TEAM
    All DoctorsEmergency + Critical CareCardiologyClient Service RepresentativesDermatologyDiabetesInternal MedicineManagement TeamNeurologyOncologyOphthalmologyRadioactive Iodine Therapy (I-131)Radiology + ImagingRehabilitation & Regenerative MedicineSurgery
    NEWS + EVENTSFEES + PAYMENTCONTACT + DIRECTIONSREFERRING VETERINARIANSPATIENT FORMSONLINE PHARMACYCOVID-19 INFO

Radioactive Iodine Referral Form

  • The following information is requested to aid in planning I-131 treatment for this patient. Please include any additional information that you feel may be relevant for the pre-treatment assessment of this patient.
  • Medical History

  • Diagnosis & Previous Treatment for Hyperthyroidism

  • Has there been previous treatment?
  • Fish meal or oil as a minor ingredient is ok
  • Medications

					            	
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Emergency, Surgical + Specialty Services

Emergency Medical Services available 24/7/365

Surgical and Specialty appointment hours are Monday-Friday 8:00AM to 5:00PM

emergency@pvesc.com
specialty@pvesc.com
surgery@pvesc.com
739 Warren Avenue
Portland, ME 04103

Ophthalmology + Dermatology Services

Monday, Tuesday, Wednesday, Friday: 8:00AM – 5:00PM

Closed Thursday
specialty@pvesc.com
2255 Congress Street
Portland, ME 04102

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