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Stack Vet - New Client Referral Form

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    Referral Policy

    You have been referred to the Stack Veterinary Hospital for a consultation on a specific problem identified by your veterinarian.

    The specialist will examine your pet, review any diagnostic test(s) already preformed, and outline some specific recommendations for further diagnostic and/or therapeutic intervention. An estimate for charges that might be incurred will be provided at the initial consultation. A deposit of 50% of the estimated charges will be required at the time your pet is admitted to our hospital and the balance is due when the pet is discharged.

    At the completion of our treatment for the referred condition, a verbal and written synopsis will be forwarded to your veterinarian. If ongoing care is required for the condition, we will coordinate with your veterinarian so that your pet receives the most appropriate treatment, and try to minimize any inconvenience to you (i.e. long distance traveling etc.).

    Please understand that your veterinarian is the professional most familiar with your pet. We will not be able to provide routine veterinary services for this pet, or any of your other pets, now or in the future. If a new problem, unrelated to the present condition, develops in the future, please consult with your veterinarian first.

    We will happily assist you in any way with questions or problems directly related to the current problem only.

    By typing my name and date below, I have read and agreed to comply with the referral policy.

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