Veterinary Practice Transfer Form

TLCC24 OVERNIGHT CARE/TRANSFER REQUEST FORM

Dear Client, this form is for veterinary practice use only; If you have an emergency please contact your usual practice where details of their emergency service provider will be available.

Please note: We will not accept any patients transfers from your clinic without completed documentation 

Relevant Documentation:

  • Full clinical history
  • Lab results including normal and abnormal results
  • Obtained diagnostic images where applicable

Referring Practice Information
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Care Level Agreement (CLA) Desired For This Case

We have two different care levels for you to choose from for your case. Please read the following information carefully to ensure that you choose the correct care level agreement for your patient.


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Client Primary Contact Details
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Patients' Details
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Case Details
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Medication
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If this isn’t the only drug, you can add another below:
Checklist
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To provide an estimate, you will need to reference our pricing list. It is a password protected file that you can access here

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