Online Referral Form – Oncology

EMERGENCY REFFERALS(Required)
PLEASE DO NOT USE THIS FORM FOR EMERGENCY REFERRALS. INSTEAD CALL OUR OFFICE AT 919-489-0615 TO SPEAK DIRECTLY TO A CLINICIAN.
Processing your referral(Required)
While we make every effort to see every patient that is referred us, there is the possibility that, due to caseload, we may be unable to accommodate your referral. In the event that we are unable to see your patient, we will notify you as soon as possible.
Referring Veterinarian(Required)
Client Name(Required)
Findings and diagnostics preformed(Required)
Indicate which of the following has been completed
Radiographs(Required)
Will radiographs be submitted to [email protected] prior to the patient appointment?
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.
This field is for validation purposes and should be left unchanged.