Referral Process

Our Professional Promise to You

Uncompromised excellence is the core of the referral service at Animal Medical & Surgical Center. All referring veterinarians receive a detailed report describing every aspect of treatment, diagnosis, and medical procedure. This may include a DVD/disc of the surgery, MRI, or CT in some cases.

It is our policy to treat referred patients only for the specific procedure for which they were referred and we will not provide any veterinary care other than what their primary doctor has requested unless complications dictate otherwise. We value the professional relationship we have with our referring veterinarians and we are available to answer any questions.

For more information about referrals to Animal Medical & Surgical Center, please contact us.

How to Refer a Patient

Download a printable referral form and fax it to us, or submit your referral request online.

Fax: 480-502-4416

Be sure to include medical records, diagnostic information, and any other pertinent case materials whether submitting by fax or online.

Please contact us at 480-502-4400 with any questions or specific requests.

Referral Forms

To refer a patient, you can complete and submit the online referral form you need, or you can download and complete the fill-able PDF document. If you choose to use our PDF forms, you can either submit the completed form through the Online Submission Form on this page, or print and bring it with you to our hospital.

Select the type of form you want to use below:

Referral Form - Web

Department*

Client Information

First Name*

Last Name*

Phone*

Patient Information

Name*

Age*

Breed*

Sex*

Referring Veterinarian*

Referring Clinic*

Phone*

Presenting Problems*

History/Physical Findings*

Pending Diagnostics*

Current Treatments, Medications, and Dosages*

Therapy Requested*

If you have more than two files to attach, please zip them into a compressed file.


PDF Referral Forms

If you would like to download the PDF, and do not already have AdobeReader® installed on your computer, click HERE to download.

Referral Form - PDF

Online Submission Form

Your Name (required)

Your Email (required)

Your Phone

1.) Complete necessary form(s)

2.) Save form(s) to computer/device

3.) Click "Choose File" below & attach your completed form

4.) Click "Send"