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Family Veterinarian Referral Form Date: Referring to: Internal Medicine Service: Sacha Mace, BA, DVM, DAVIS & Teresa Dye, DVM, DACES, DAVIS Regenerative Medicine Service: Kara Keeling, DVM Orthopedic

How to fill out family veterinarian referral form

How to fill out a family veterinarian referral form:

1. Start by gathering all the necessary information about your pet, including their name, age, breed, and any medical conditions or concerns you have.
2. Fill out your own personal details, such as your name, contact information, and relationship to the pet.
3. Provide information about your current veterinarian, including their name, contact information, and any relevant medical records or treatment history.
4. Specify the reason for the referral, whether it's for a specialized treatment, surgery, or a second opinion.
5. Indicate any specific instructions or preferences you have for the referral, such as a certain specialist you'd like to see or any specific concerns you want addressed.
6. Sign and date the form to confirm your consent to the referral process and authorize the release of your pet's medical records.
7. Keep a copy of the completed referral form for your records before sending it to your family veterinarian.

Who needs a family veterinarian referral form:

1. Pet owners who wish to have their pet receive specialized or advanced medical care.
2. Individuals seeking a second opinion or alternative treatment options for their pet's condition.
3. Those who want to consult with a specialist or expert in a particular field of veterinary medicine.
4. Pet owners who wish to transfer their pet's medical records and treatment history to a different veterinarian.
5. People looking for recommendations from their current veterinarian on where to seek specialized care for their pet.

Remember, it's always best to consult with your family veterinarian to determine if a referral is necessary and to have guidance on how to properly fill out the referral form.

For pdfFiller’s FAQs

What is family veterinarian referral form?

The family veterinarian referral form is a document used to refer clients to a specific veterinarian for their family pets.

Who is required to file family veterinarian referral form?

Pet owners who wish to transfer their pets to a new veterinarian are required to fill out the family veterinarian referral form.

How to fill out family veterinarian referral form?

To fill out the family veterinarian referral form, pet owners need to provide their contact information, their pet's medical history, and the reason for transferring to a new veterinarian.

What is the purpose of family veterinarian referral form?

The purpose of the family veterinarian referral form is to ensure a smooth transition of care for the family pet from one veterinarian to another.

What information must be reported on family veterinarian referral form?

The family veterinarian referral form must include the pet owner's contact information, the pet's medical history, current medications, and reason for seeking a new veterinarian.

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