Trainer Referral Form
Virtual Veterinary Behavior Medicine (VVBM) offers remote consultations for your clients to deliver specialty care straight to their home.
Prior to Scheduling
When you submit a referral, we will reach out to the pet's primary care provider. Prior to the virtual consult, the primary care veterinarian is required to attest to the physical health of the pet and to provide details of a recent physical exam and any lab work.
Appointments
Appointments typically last 45-60 minutes
A written summary of the appointment and treatment recommendations will be emailed to the client and the referring veterinarian.
Changes to the treatment plan can be made by email communication for a one month follow-up period after the appointment, as long as the referring veterinarian is involved in all communications and will take responsibility for any recommended medication changes.
After the one month follow up period, any changes will require a recheck appointment
There will be NO phone call consultation between the client and behavior clinician after the initial appointment. All follow-up contact between the client and behavior clinician must be conducted through email, with the referring veterinarian copied.
Scheduling
Appointments are scheduled online at vvbm.vet
Full payment is required at the time of scheduling.
For the referring trainer to fill out:
Trainer Name:
*
Trainer Email Address:
*
Client Name (First, Last)
*
Client Phone
*
Client Email:
*
Patient Name
*
Patient Breed
*
Patient Age
*
Patient Sex
*
Neutered/Spayed (Please type which one below or "no" if neither)
*
Reason for Referral:
*
Preview PDF
Submit
Should be Empty: