306-745-6642 tvvstaff@sasktel.net

Facebook

Facebook

Home
About Us
Services
Resources
join our team
Contact
Appointment
our online store

Select Page

Online Forms

Referral Form

Save time during your next appointment! Complete your required forms online
from any device at any time before your visit.

Get Started

Referral Form

Date *

Doctor Name *

First

Last

Practice Name *

Laboratory Name

Doctor E-mail *

Doctor Phone *

Doctor Fax

How would you like to be contacted?

Phone
Email
Fax

Client Name *

First

Last

Patient Name *

First

Last

Patient Species *

Dog
Cat
Other

Please upload lab reports, x-rays, and other diagnostics.

Click or drag a file to this area to upload.

Additional Upload (if necessary)

Click or drag a file to this area to upload.

Additional Upload (if necessary)

Click or drag a file to this area to upload.

Additional Upload (if necessary)

Click or drag a file to this area to upload.

Patient History

Diagnostic Information

Treatments / Medications

As the referring veterinarian, my expectations for this case are as follows: (Please check one.)

Referral for procedure(s)
Hospitalization and definitive care
Overall management of care for the diagnosis
Overnight care and return in the morning

Is there any more information we should know?

Questions?

Get in touch! Complete our form, and a member of our team will be in touch with you shortly.



Contact

Phone: 306-745-6642
Fax: 306-745-6643
E: tvvstaff@sasktel.net



Location

424 Maple Street
Esterhazy, Saskatchewan
S0A 0X0



Opening Hours

Monday: 8:00 am – 7:30 pm
Tuesday: 8:00 am – 12:30 pm; 1:30 pm – 5:00 pm
Wednesday to Friday: 8:00 am – 5:00 pm
Saturday-Sunday: Closed

Name *

First

Last

Email *

Phone

How can we help you? *

Message