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1054 E. Old Canyon Ct. Flagstaff, AZ 86001 Phone: (928) 7745197 Fax: (928) 7745278 www.canyonpet.comREFERRAL FORM Date: Referring Veterinarian: Hospital: Telephone: () Fax: () Client Name: Client
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To fill out the referring veterinarian section, please complete the following steps:
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Obtain the necessary information about the referring veterinarian, such as their name, address, phone number, and fax number.
03
Enter the referring veterinarian's name in the designated space provided on the form.
04
Include the complete address of the referring veterinarian, including street address, city, state, and ZIP code.
05
Enter the referring veterinarian's phone number and fax number, if available.
06
Double-check all the information entered for accuracy and make any necessary corrections.
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Submit the completed referring veterinarian section along with the rest of the required information or documents.

Who needs referring veterinarian please complete?

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Anyone who is seeking medical treatment for their animal from a specialist or another veterinary professional may need to fill out the referring veterinarian section. This could include pet owners or caretakers who are seeking specialized care, second opinions, or consultations for their animals. Additionally, veterinarians themselves may need to fill out this section when referring their patients to other specialists or veterinary practices.
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A referring veterinarian is a veterinarian who refers a patient to a specialist or another veterinary practice for further diagnosis, treatment, or consultation.
Referring veterinarians are required to file when they refer patients to specialists or other practices for specialized care.
To fill out referring veterinarian documentation, include details such as the patient's medical history, the reason for the referral, and any relevant diagnostic information.
The purpose of a referring veterinarian is to ensure that patients receive the necessary specialized care that may not be available at the primary veterinary practice.
Information that must be reported includes the patient’s identification, the nature of the condition, referral details, and any relevant medical records.
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