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Extracorporeal Referral Form

This service is for veterinarians only – clients seeking medical information should contact their regular veterinarian for assistance.

If you would like to make a referral to one of the VH Services and you do not need to talk to a VH clinician, you can use this form to submit the client and patient information. Please indicate on the form if you have told the client to call the VH, or if you would like us to call them. Please provide a summary of the history of the case so that we can be prepared to provide the patient with the appropriate care. Please send or fax supporting information. Please send radiographs or other images with the client or by submitting directly to us through eFilm (see instructions on main information for Referring Veterinarians page).

We strive to provide quality care to all patients admitted to our hospital and under our care. Because of current hospital-wide shortages, we are limiting referral appointments on a case-by-case basis for the time being. After receipt of your referral request, we will reach out to you and notify you if we cannot schedule the patient in a timely manner. Please note that the first available appointments for non-urgent referrals may be several months from the time the request for referral is made.