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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
  • This field is for validation purposes and should be left unchanged.