Referral Appointment Request Please complete the form below to request an appointment for your client. *If you are sending a referral to James River Veterinary Surgery, please do not use this form, but head over to their website. Please enable JavaScript in your browser to complete this form.Service referring to: *OncologyUrgent CareYour InformationReferral Veterinarian Name *FirstLastPhone *Email *Hospital Name *Client & Patient InformationName *FirstLastPhone *Pet's Name *Species *Canine FelineBreedAgeReason for Referral/Suspected Diagnosis *Have any of the following tests been performed within the last 2 months? *No testing performedCBCChemistry profileUrinalysisThyroid TestingAbdominal radiographsAbdominal ultrasoundThoracic radiographsCytologyHistopathologyCancer screening tests (Nu. Q or PetDx)CADET BRAF urine testOtherPlease list test performed *Please attach any digital records, diagnostics or other case-related material that you would like to include with this referral. Click or drag a file to this area to upload. File Upload Click or drag a file to this area to upload. File Upload (copy) Click or drag a file to this area to upload. File Upload (copy) (copy) Click or drag a file to this area to upload. Submit