CT Referral Form

Referral Instructions: When referring your patient to SAVE, please complete this online submission form. All pertinent medical records can be uploaded through this form or submitted via email to admin@saveveterinary.com.

 

Note: To ensure seamless service for your clients, we kindly ask that you complete this form and send it along with relevant medical records, blood work and radiographs prior to your client calling to schedule an appointment.

 

Today
Urgency Level *

 

Call ER to speak with an ER vet about urgent cases before transferring the patient.

Contrast *

 

CT Results will be sent to the referring practice to be followed up with pet owner.


REFERRING VETERINARIAN INFORMATION

CLIENT INFORMATION

PATIENT INFORMATION

WAIT TIME ACKNOWLEDGEMENTS

 

Ensure your client was informed that for non-urgent cases, there may be wait times of 1-4 weeks for initial consultation and/ or procedure, but the clients will be contacted as soon as all medical records are received to advise of appointment timing. Urgent cases take priority over non urgent cases.

REFERRAL INFORMATION


*diagnostic results will be sent to you to follow up with your client

DOCUMENTS


Please upload any information such as medical records, lab results, or additional sheets.

Files Uploaded




Thank you for taking the time to complete this form. A member of our team will be in contact with you as soon as possible.
 


 

 
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