Referral FormHome » Referral Form Search for: Have you heard?CARE has a new online portal.Though the form below continues to work, we encourage you to submit your referral through our new portal here. Please contact us if you have any questions. Vet Referral FormToday's date * Emergency * YesNoOwner * Phone * Address * City * State * Zip * Service Patient is Being Referred To: * ---CardiologyEmergencyInternal MedicineNeurology and NeurosurgeryOncologyOphthalmologyRadiologySurgeryPet Name * DOB If date of birth is unknown, please provide approximate age in years and months.Pet's # years * Pet's # months Species * Breed * Sex * Current Rabies Vaccination * YesNoReason for Referral * Referring Doctor * Referring Clinic Email Fax How would you like us to communicate with you regarding patient information? (discharges, updates & lab results) * EmailFaxAdditional information For referring Veterinarians: We promise to keep your contact information confidential and send only material that is important and relevant to you and your patients, such as continuing education opportunities, specialist's scheduling updates, and other important events; please provide your best email address to receive this material. Email * Fields marked with this are required If you prefer, download, complete and email our Veterinary Referral Form to [email protected].