Horse Heaven Hills Pet Urgent Care and Veterinary Center

Referral

Please fill out this form to the best of your knowledge. Someone will be in contact with you shortly. Please do not use this form to book general practice appointments.

Are you a DVM?

Referring DVM Name

First Name

Last Name

Referring DVM Hospital

Referring DVM Phone

(###)

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Referring DVM Email

Owner Name

First Name

Last Name

Owner Phone

(###)

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Owner Email

Patient Name, Breed, Sex, Weight, and Age

Relevant Clinical Problems

Current Medications

Type of Procedure Requested

Region of Procedure (Body Part)

DDx/Rule Outs

Date

MM

DD

YYYY

Email for Radiology Report: (Please allow 48-72 for reporting unless requested STAT (3 hours))

Following our recent evaluation, we recommend a referral to a veterinary specialty clinic for a more in-depth assessment and specialized care. It's crucial to note that while we strive to convey accurate information, we cannot guarantee the replication of diagnostics by the specialty clinic. Their decision to conduct additional tests is based on their evaluation of your pet's unique needs. Horse Heaven Hills Pet Urgent Care and Veterinary Center is not liable for any diagnostics that may or may not be repeated. Your pet's well-being is our utmost priority, and we suggest discussing any concerns regarding diagnostics directly with the specialty clinic during your visit.

Referral

Horse Heaven Hills Pet Urgent Care & Veterinary Center