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Get Utcvm Referral Form 2011-2025
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How to fill out the UTCVM Referral Form online
The UTCVM Referral Form is essential for referring patients to the University of Tennessee Veterinary Medical Center. This guide will walk you through the process of filling out the form online with clear, step-by-step instructions to ensure a smooth submission.
Follow the steps to complete the UTCVM Referral Form online.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin filling out the patient details. Enter the Patient Name or ID and the UTCVM Medical Record Number, if applicable. Make sure to confirm the species, breed, sex, and age of the patient.
- Input the owner’s information. Provide the owner’s name, contact numbers (home, work, and cell), and the street address, city, state, and zip code.
- Fill in the patient’s weight and color, as well as the date of referral. Ensure that this information is accurate and updated.
- Indicate copies of pertinent medical records, radiographs, and lab results that will accompany the patient. Specify whether these will be sent with the client, mailed, or emailed.
- Include the clinical diagnosis or reason for the referral, and note any potential adverse vaccine reactions. This will aid in the patient's care.
- List any pertinent lab results, medication, or treatment that the patient is currently undergoing. Attach copies if available.
- Indicate the preferred clinical service you are referring the patient to by checking the appropriate box.
- Make sure to specify if you, as the referring veterinarian, have informed the owner of the deposit policy and provided an estimate for treatment costs.
- Finally, review all filled sections for accuracy. Save your changes, download, print, or share the completed form as needed before submission.
Complete the UTCVM Referral Form online today for a streamlined referral process.
Filling in a referral form requires attention to detail. Start by entering the referring veterinarian’s information and the pet’s details accurately. Lastly, include any specific medical issues on the UTCVM Referral Form to ensure the specialist has all the information needed.
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