URGENT NOTICE: Our ER is experiencing a high volume of cases. Please call ahead so we can talk you through your pet’s situation and prepare for your arrival.

FOR VETS- Canine Rehabilitation & Rehabilitation Referral Form

Save time during your next appointment! Complete your required forms online from any device at any time before your visit.

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Online Forms

Please note: Have clients call to schedule an appointment if you are sending in a referral.

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit. If this is an emergency, or if your pet needs urgent care, please call us at 716-646-4023 for a faster response.

Hospital Information

Client Information

Pet Information

Referral Information

Has the patient had bloodwork, x-ray's, or other diagnostics recently (related to the case)? Please attach anything related to this case at the end of the consult form or send results with the client at time of consult.

Medical Records

Please be sure to include all medical notes pertinent to the concern. If the concern has been ongoing for 6 months, please send everything for 6 months. If the concern has been ongoing for 6 years, please send everything for 6 years.


If you have completed any lab work or other test results, please attach here:


This may include:



• Chemistry

• Urinalysis

• Thyroid Testing

• Pathology/Cytology

• HW/Lyme/Ehrlichia/Anaplamsa


• Blood Pressure

• Surgery Reports Related to Concern

• Radiographs

• Ultrasound Studies

• CT


• Other

Click or drag files to this area to upload. You can upload up to 14 files.