Refer A Patient

Thank you for choosing Veterinary Cardiopulmonary Care Center as your partner for cardiopulmonary care. We sincerely appreciate the opportunity to work with you to care for your patients.

How to Refer a Case

Simply choose the method that’s most convenient for you:

By telephone: Call us at 561-440-0084 to arrange a consultation, discuss a case, or obtain an estimate of fees. If our doctors are unavailable, our Client Liaisons are here to help and provide immediate advice.
Using our Referral Form
- Web Form: use the web form below.
- Fax: Click below to print out our referral form; complete and fax it to 561-403-1102
- Print a Hard Copy: Click here to print out our referral form; complete it and give to your client to bring to their first appointment.
  NOTE: Your client must call us at 561-440-0084 ext 2 to schedule a consultation.

Referring Veterinarian

Name

Hospital

Address

City

Zip

Phone

What is your reason for referral?

Client & Pet Information

First Name

Last Name

Pet Name

Species

Age

Breed

What is your pet's history?

Diagnostics

Treatments & Medications

Enclosures

(Simply indicate what you plan on forwarding, if any)

Lab Reports Radiographs Other

You can fax or email enclosures to fax number 561-403-1102 or email to records@vetccc.com. Or feel free to upload them as part of this form by clicking on the 'Add Files' button below.

Document Upload