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REFERRAL FORM

Referring a Patient

At East Tennessee Veterinary Dentistry, we know your time is valuable and want to make the referral process as smooth as possible. We welcome the opportunity to partner with you in providing advanced dental and oral surgery care for your patients.

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How to Refer:

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  • Email patient records to: etvetdental@gmail.com

  • Call us at: 865-229-8361

  • Or, fill out and attach records to the referral form below.

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Our team is here to support you every step of the way. Please don’t hesitate to reach out with any questions—we look forward to collaborating with you to provide the highest quality of care for your patients.

REFERRING VETERINARIAN INFORMATION

CLIENT INFORMATION

PATIENT SEX
DATE OF BIRTH
Month
Day
Year
HAVE DENTAL RADIOGRAPHS BEEN TAKEN OF THIS PATIENT? IF YES, PLEASE EMAIL THOSE OVER OR ATTACH BELOW
YES
NO
Add up to 10 files
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