Veterinarian Referral Form

Veterinarian Referral Form

For veterinarians referring their client to Dr. Kyla Boas for an in person behavior consultation, please fill out the form below.
We offer several behavior services for referral patients:
- Comprehensive Behavior Consultation: Through this detailed appointment, Dr. Boas meets with the client and patient in person, discusses the complete history, and develops a behavior treatment plan including management, behavior modification, and medication, if appropriate.
- Clinic Confidence Appointments: This appointment series is structured to build a pre-visit medication protocol and guide the owner in developing handling skills with their pet through cooperative care methods. The goal is to develop a veterinary appointment plan to provide safety and support for the staff and patient during an appointment and/or sedation. This appointment series is not used to postpone necessary care. Instead, our focus is setting the client and pet up with the tools to prepare for their next veterinary appointment.
- Vet-to-Vet Consultations: In cases where an in person comprehensive consultation is not necessary or possible, or for a veterinarian who is seeking detailed guidance on next steps in the behavior treatment, vet-to-vet counseling is available. We have a separate form on our website to request this appointment option.
Medical records can be emailed to behavior@cassvetservice.com.

After receiving this form, the Veterinary Behavior Specialty Service team will contact your client directly to schedule. After your client's initial appointment and any future recheck appointments, we will send a copy of the discharge discussion to your clinic.

Please note that it may take 48-72 hours for our staff to contact the owner to schedule an appointment.
Referring clinic's name:
Referring veterinarian's name:
Phone number of referring veterinary clinic:
Please enter a valid phone number.Format: (000) 000-0000.
Email address of referring veterinary clinic:
example@example.com
Name of client:
Client's phone number:
Please enter a valid phone number.Format: (000) 000-0000.
Client's email address:
example@example.com
Name of patient:
DogCatOther
Patient age:
Patient breed:
Intact femaleSpayed femaleIntact maleNeutered male
Chief complaint and/or diagnosis:
History and physical exam findings:
Treatments (previous and current):
For medications, please list names, doses, and frequency.
Current medications (behavior and non-behavior):
Please list names, doses, and frequency.
Additional requests or comments:
Should be Empty: