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Online Referral Form

 

This form may only be submitted by a licensed veterinarian. Critical Care and Emergency referrals must be called in to (713) 693.1111

This form may only be submitted by a licensed veterinarian. Critical Care and Emergency referrals must be called in to (713) 693.1111

  • Client/Patient Information

  • Medical records, pertinent lab results and diagnostic images.

  • **Please submit medical reports, lab results or diagnostic images with this form. You may select and upload multiple files at once, or attach a single .zip file.
    Drop files here or
    Max. file size: 300 MB.
    • This field is for validation purposes and should be left unchanged.