Specialist Referral Form

We share your goal of delivering personalized patient care and high client satisfaction. Our hospital is open 24 hours daily including nights, weekends and holidays. Our Acupuncture, Internal Medicine, Oncology, Rehabilitation, and Surgery teams are available for referrals, Monday through Friday 8:00am–5:00pm.

 

For Patient Record Access:
You may access referred patient records and refer new patients through the Referring Veterinary Portal here.

New Hospitals and Veterinarians:
If you do not have an account in the Referring Veterinary Portal please complete and submit the below online referral form and attach patient records and radiographs as needed.

If you prefer you may email patient records and radiographs to info@bevsvt.com or mail to 200 Commerce Street, Williston, VT 05495

 

Referring Veterinarian's Information

Referring Veterinarian's Name:

Referring Veterinarian's Phone:

Hospital Name:

Client's Information

Client's Name:

Client Phone/s:

Home Phone:

Work Phone:

Cell Phone:

Client's Address:

Client's E-mail Address:

Patient's Information

Name:

Breed:

Age:

Sex:

Spayed/Neutered:

Weight: lbs

Patient's History

Client Complaint/History:

Clinical Problem/s:

Laboratory and/or Radiograph Results:

Medications:

Attachement a file:

You may call and speak with one of our specialists to discuss a case Monday through Friday 8:00am–5:00pm. Our doctors will communicate with you throughout your patient’s treatment process to assist you in providing appropriate follow-up care. All medical records and test results will be sent to you within 24 hours of the patient’s discharge.