Online Referral Submission

Thank you for entrusting your patient with our care.

CARE Referral

Referring Veterinarian

Referring Clinic

Clinic Email

Clinic Phone

Client Name

Patient's Name

Client Email

Client Phone

Reason For Referral

Goals/Expectations for Referral

Approved Date To Start Rehab

Month

Day

Year

If Additional Diagnostics are recommended

Please Proceed With Internal Diagnostics

Please Refer Back For Diagnostics

Please email all medical records pertaining to patient being referred for rehabilitation and all diagnostics that have been completed to info@carevetservices.com.

Signature

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In accordance with Texas Veterinary Board Rules, as the supervising Veterinarian, I have established a valid veterinarian / client / patient relationship and have determined that rehabilitation will not likely be harmful to this patient.

Creating More Good Days Together

Compassionate Care for Every Step of Your Pets Journey.