Veterinary Dental Referral Form Please enable JavaScript in your browser to complete this form.Primary Reason for ReferralReferring DVM Information:Name of Hospital or ClinicVeterinarianrDVM requests phone consult with Dr. Hoover:YesNorDVM EmailrDVM PhonerDVM FaxPatient Information:Pet NameBreedColorSexMMNFFSAge / Date of BirthClient Information:Owner’s NameOwner's Phone NumberOwner's EmailClient Communication: VDCNC's staff will email the referred pet's owner within two business days to continue the referral process. rDVM Patient Records:Please submit the following information for the referred pet via an attachment below:Attach Doctor's notes Click or drag a file to this area to upload. Attach laboratory results, including histopathology results Click or drag a file to this area to upload. Attach previous dental charts Click or drag a file to this area to upload. Attach previous anesthesia summaries Click or drag a file to this area to upload. Attach dental radiographs Click or drag a file to this area to upload. If you have more photos or files to send, please email them directly to info@vdcnc.com. Referral requests are reviewed within one business day of submission. VDCNC hours of operation are Monday-Thursday, so referrals submitted on Thursday and Friday will be reviewed on the following Monday. *I have read and understand.EmailSubmit