MedVet

MedVet Houston Bay Area - Cardiology, Critical Care, Internal Medicine, and Surgery

Thank you for referring your valued client and their pet to our practice. In order to facilitate the referral process, we ask you or your staff to complete following:

Please send all pertinent medical records with this referral form.
Please ask your client to bring their pet, all current/recent medications, radiographs or other imaging data to their appointment.

For urgent referrals to our critical care department please call us at (281) 464.3554.

Referring Veterinarian(Required)

Clinic Name(Required)

Client Name(Required)

Pet Name(Required)

Pet Species

Canine

Feline

Pet Age or Date of Birth(Required)

Pet Sex

Pet Breed

Address(Required)

Street Address Address Line 2 City State ZIP Code

Client Phone Number(Required)

Client Email(Required)

Requested Department(Required)

Cardiology

Critical Care

Internal Medicine

Surgery

Unsure

How soon does patient need to be seen?(Required)

Emergent

Soonest available

Chief Complaint/Reason for Referral(Required)

Medical History

Has the patient had bloodwork/imaging performed?

Bloodwork

X-rays

Ulltrasound

Advanced Imaging

Upload Bloodwork/Imaging

Drop files here or

Accepted file types: jpg, gif, png, doc, pdf, Max. file size: 50 MB.

Upload Medical History

Drop files here or

Accepted file types: jpg, gif, png, doc, pdf, Max. file size: 50 MB.

You should receive a written faxed referral report within 24 hours of the patient being discharged from the hospital. Please let us know if you would like an alternate method of delivery or you would like additional information.