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Emergency
Phone: 209-669-8600
1231 W. Taylor Rd. Turlock, CA 95382
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Veterinary Patient Transfer Form
Transferring Hospital Name
*
Transferring Hospital Phone #
*
Transferring Veterinarian Name
*
Name
Transferring Veterinarian Direct contact information (Cell phone, email) *optional*
Client First & Last Name
*
First
Last
Patient Name
*
Pet's Name
Species
*
Cat
Dog
Sex
*
Intact Female
Spayed Female
Intact Male
Neutered Male
Age
*
Weight
*
Breed
*
Chief Complaint/History
*
Diagnosis
*
Diagnostics Performed
*
Drugs Given & Drugs being sent with patient
*
Requesting Reason for Transfer
*
Is the client prepared for continued cost of treatment?
*
Yes
No
Not Discussed
Estimated Date of Arrival
*
MM
DD
YYYY
Estimated Time of Arrival
*
Special Instructions
*
Upload Medical Records and Radiographs
Coronavirus Information
Home
Services
Wellness Care
Acupuncture
Boarding
Palliative & Hospice Care
Surgery
Emergency Services
About Us
Contact
Take A Tour
Team
Make an Appointment
Online Pharmacy Info
Veterinary Patient Transfer Form
Promotions & Special Offers
Contact Us
Pet Health
Pet Health Library
How-To Videos
Pet Health Checker
Pet Food Recalls
Product Recalls
FAQ’s & Resources
Pet Insurance Info
News
Pharmacy