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Referring Veterinarians
Services
Canine Rehabilitation
Evaluations
Canine Arthritis Pain
Synovetin OA
Meet Our Team
Referring Veterinarians
Call (717) 652 1270
Referring Veterinarian Form
Please email any necessary records to
[email protected]
Referring Veterinarian's Name
(Required)
Veterinary Hospital
(Required)
Hospital's Phone Number
(Required)
Hospital's Email
(Required)
Owner's Information
Owner's Name
(Required)
First
Last
Owner's Phone
(Required)
Owner's Email
(Required)
Patient's Information
Pet's Name
(Required)
Species
(Required)
Canine
Feline
Other
Breed
(Required)
Age
(Required)
Sex
(Required)
Male
Female
Neutered Male
Spayed Female
Please provide the patient's medical history/clinical signs.
(Required)
Please list the patient's current medications.
(Required)
Please provide the working diagnosis.
(Required)
Please list the diagnostics performed and the results.
(Required)
Please select your goal(s) for rehab referral.
(Required)
Pain management/quality of life/return to function
Orthopedic Surgery
Pre/post operative rehab
Avoid surgery/conservative management
Second opinion/ unknown case of lameness and/or pain
Diagnostic musculoskeletal ultrasound
Synoventin OA treatment
Other intra-articular therapy (PRP, Arthramid, Spryng, etc)
Other
How would you prefer to be contacted regarding this case?
(Required)
Phone
Email
Other
Emergency Care
Emergency & Urgent Care
Book an Appointment
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