If you are a veterinarian referring a case to us, please complete the form.

We will reach out to your client to schedule their pet within 72 hours. A visit summary will be sent to your office following the patient's visit to RVEC.

Referrals

If this is an emergency during our normal business hours, please contact us by phone directly at 585-515-0212.

IS THIS AN URGENT REFERRAL (NEEDS TO BE SEEN WITHIN 72 HOURS)?

YES

Referring Doctor's Name

Hospital Name

Hospital phone #

Reason For Referral / Comments

Owner's Name

Owner's Phone #

(###)

###

####

Owner's Email

Pet's Name

Age

Breed

Sex

Current Medications