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Learn more about our

You can download a printable copy of our referral and transfer forms and fax the completed forms to us at 919-213-6664 or you can submit your referral or transfer using the online submission forms below.

Please note that online submissions are checked daily at 9am, 2pm and 6pm. If you have an urgent case that requires a more immediate response or would like to make an emergency referral, please call the hospital at 919-489-0615.

Online Referral Form - Cardiology

EMERGENCY REFERRALS

PLEASE DO NOT USE THIS FORM FOR EMERGENCY REFERRALS. INSTEAD CALL OUR OFFICE AT 919-489-0615 TO SPEAK DIRECTLY TO A CLINICIAN.

My patient does not need to be referred to the emergency department

Sedation Needed?

Yes

Referring Veterinarian

First Name

Last Name

Referring Hospital

Hospital Phone Number

(###)

###

####

Client Name

First Name

Last Name

Pet Name

Client Phone Number

(###)

###

####

Species

Breed

Age

Sex

Reason for Referral

Findings and Diagnostics Performed

Radiographs

Will radiographs be submitted to cardiology@trianglevrh.com prior to the patient appointment?

Yes

Current Medications

Additional Comments

Behavioral concerns or medications

Follow up

How would you like the next contact to be made? If selecting "TVRH to call client", our CSR team will reach out to the client within 36 hours of receiving this referral.

Online Referral Form - Internal Medicine

EMERGENCY REFERRALS

PLEASE DO NOT USE THIS FORM FOR EMERGENCY REFERRALS. INSTEAD CALL OUR OFFICE AT 919-489-0615 TO SPEAK DIRECTLY TO A CLINICIAN.

My patient does not need to be referred to the emergency department

Sedation Needed?

Yes

Referring Veterinarian

First Name

Last Name

Referring Hospital

Referring Email

Hospital Phone Number

(###)

###

####

Client Name

First Name

Last Name

Pet Name

Client Phone

(###)

###

####

Species

Breed

Age

Sex

Reason for Referral

In addition to the fields below, please send the last year of records, including exam notes, lab results, imaging and imaging reports to internalmedicine@trianglevrh.com.

Findings and Diagnostics Performed

Radiographs

Will radiographs be submitted to internalmedicine@trianglevrh.com prior to the patient appointment?

Yes

Current Medications

Additional Comments

Behavioral concerns or medications

Follow up

How would you like the next contact to be made? If selecting "TVRH to call client", our CSR team will reach out to the client within 36 hours of receiving this referral. If selecting DVM-to-DVM consult, email us at internalmedicine@trianglevrh.com with a case summary including the clinical signs, diagnostics performed (including dates and results), treatments attempted, response to each attempted treatment and your specific questions. Medical records can be attached or sent to internalmedicine@trianglevrh.com, but a written summary is required. Our clinician is happy to offer guidance. Average turnaround time for stable doctor-to-doctor consults is 3-10 business days.

Referral Form - Neurology

EMERGENCY REFERRALS *

PLEASE DO NOT USE THIS FORM FOR EMERGENCY REFERRALS. INSTEAD CALL OUR OFFICE AT 919-489-0615 TO SPEAK DIRECTLY TO A CLINICIAN.

My patient does not need to be referred to the emergency department

Sedation Needed?

Yes

Referring Veterinarian

First Name

Last Name

Referring Hospital

Hospital Phone

(###)

###

####

Client Name

First Name

Last Name

Pet Name

Client Phone

(###)

###

####

Species

Breed

Age

Sex

Reason for Referral

Findings and Diagnostics Performed

Radiographs

Will radiographs be submitted to neurology@trianglevrh.com prior to the patient appointment?

Yes

Current Medications

Additional Comments

Behavioral concerns or medications

Follow up

How would you like the next contact to be made? If selecting "TVRH to call client", our CSR team will reach out to the client within 36 hours of receiving this referral.

Referral Form - Radiology

EMERGENCY REFERRALS

PLEASE DO NOT USE THIS FORM FOR EMERGENCY REFERRALS. INSTEAD CALL OUR OFFICE AT 919-489-0615 TO SPEAK DIRECTLY TO A CLINICIAN.

My patient does not need to be referred to the emergency department

Referral Service

Radiograph reviews will be completed in 1-2 business days

Sedation

TVRH is unable to offer sedated OPUS. If sedation is needed the patient will need to come through our Emergency or Specialty Services

Sedation is not needed

Type of outpatient ultrasound requested

Cardiac ultrasounds are performed via consultation with the cardiology service

Abdominal

Cervical (focal area of the neck, thyroid, lymphnodes)

Other (please specify below)

Referring Veterinarian

First Name

Last Name

Referring Hospital

Hospital Phone Number

(###)

###

####

Client Name

First Name

Last Name

Pet Name

Client Phone Number

(###)

###

####

Species

Breed

Age

Sex

Reason for Referral

Findings and Diagnostics Performed

Will radiographs be submitted to Referrals@trianglevrh.com prior to the patient appointment?

Yes

Current Medications

Additional Comments

Behavioral concerns or medications

Follow up

How would you like the next contact to be made? If selecting "TVRH to call client", our CSR team will reach out to the client within 36 hours of receiving this referral.

Online Referral Form - Rehabilitation

EMERGENCY REFERRALS

PLEASE DO NOT USE THIS FORM FOR EMERGENCY REFERRALS. INSTEAD CALL OUR OFFICE AT 919-489-0615 TO SPEAK DIRECTLY TO A CLINICIAN.

My patient does not need to be referred to the emergency department

Sedation Needed?

Yes

Referring Veterinarian

First Name

Last Name

Referring Hospital

Hospital Phone

(###)

###

####

Client Name

First Name

Last Name

Pet Name

Client Phone

(###)

###

####

Species

Breed

Age

Sex

Reason for Referral

Findings and Diagnostics Performed

Radiographs

Will radiographs be submitted to rehabilitation@trianglevrh.com prior to the patient appointment?

Yes

Current Medications

Additional Comments

Behavioral concerns or medications

Follow-up

How would you like the next contact to be made? If selecting "TVRH to call client", our CSR team will reach out to the client within 36 hours of receiving this referral.

Online Referral Form - Surgery

EMERGENCY REFERRALS

PLEASE DO NOT USE THIS FORM FOR EMERGENCY REFERRALS. INSTEAD CALL OUR OFFICE AT 919-489-0615 TO SPEAK DIRECTLY TO A CLINICIAN.

My patient does not need to be referred to the emergency department

Sedation Needed?

Yes

Referring Veterinarian

First Name

Last Name

Referring Hospital

Hospital Phone

(###)

###

####

Client Name

First Name

Last Name

Pet Name

Client Phone

(###)

###

####

Species

Breed

Age

Sex

Reason for Referral

Findings and Diagnostics Performed

Radiographs

Will radiographs be submitted to surgery@trianglevrh.com prior to the patient appointment?

Yes

Current Medications

Additional Comments

Behavioral concerns or medications

Follow up

How would you like the next contact to be made? If selecting "TVRH to call client", our CSR team will reach out to the client within 36 hours of receiving this referral.