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GCVS Referral Form

  • This form may only be submitted by a licensed veterinarian.
  • CLIENT/PATIENT INFORMATION

  • MEDICAL RECORDS, PERTINENT LABWORK AND RADIOGRAPHS

  • Please email, fax or send copies of radiographs with the owner.

  • **Please send current lab work, biopsy reports, and medical records with this form. You may select and upload multiple files at once, or attach a single .zip file. We appreciate the opportunity to work with your patients and we look forward to supporting the relationship you have with them.
    Drop files here or
    Accepted file types: zip, jpg, bit, docx, gif, png, pdf, bmp, dcm, doc, xls, xlsx.
  • This field is for validation purposes and should be left unchanged.