Veterinary Referral

Referral Policy

Our clinic is a veterinary dermatology specialty clinic accepting consultations by referral. A referral completed by your family veterinarian will provide us with the most detailed picture of your pet’s health from past to present. It also allows us to communicate regularly with your primary veterinarian and work together to provide the best possible care for your pet. We will do our best to treat your pet for their skin, allergy or ear condition, but routine veterinary services must continue through your family veterinarian.

We ask that you wait to do a biopsy or allergy test, and allow the Petderm team to assess the patient first, as it gives us the best chance to help your client and their pet.

In order to provide the best care possible, we ask that all referrals are done online through our website. We will contact you once we have booked your client for an appointment. If you are having any difficulty with this or you need to source an alternative way to refer, please see our Client Self Referral policy.

    Owner Information

    Last Name*

    First Name*

    Cell Number*

    Home Number

    Email Address*

    Home Address

    Street Address

    Address Line 2

    City/Town

    Province

    Postal Code

    Pet Information

    Name*

    Breed

    Sex

    Weight

    Colour

    Behaviour

    Pet Birthdate

    Day
    Month
    Year

    Family Vet Information

    Referring Clinic*

    Referring Veterinarian*

    Phone Number*

    Email*

    Clinic Address

    Street Address

    Address Line 2

    City/Town

    Province

    Postal Code

    Has this client been to any other veterinary clinics?

    Veterinary History

    Reason for Referral*

    How long has the problem been going on?*

    Relevant dermatological history*

    Any other health issues not dermatology related?*

    Relevant diet history/information*

    Additional Information

    Is the pet on ectoparasite/endoparasite controls?

    Please list all diagnostic tests performed

    Additional comments and / or concerns

    Relevant Images of Skin or Medical History

    Files must be smaller than 5mb. If your file is larger than 5mb, please email it directly to referrals@petderm.ca.

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