Vet to Vet: Veterinarian Request Form

Vet-to-Vet Request Form

This request form is for a Vet-to-Vet counseling request; for veterinarians referring their client to Dr. Kyla Boas for a complete behavior consultation, please use the form on our website titled "Veterinary Referral Form".
Vet-to-Vet counseling is conducted between Dr. Kyla Boas and the patient's primary veterinarian. Dr. Boas does not have any direct content with the patient's owner during this service. Implementation of recommendations, prescriptions, discussion, and follow-up with the owner is the responsibility of the primary veterinarian.

What can you expect?

1. The primary veterinarian submits this request form to the Veterinary Behavior Specialty Service. Relevant medical records (including previous or current prescriptions, radiographs or blood work, and recent physical exam findings) can be emailed to behavior@cassvetservice.com.

2. The charge for this appointment is billed directly to the primary veterinary clinic. The primary veterinary clinic may charge their client as they feel is appropriate.

3. The client is contacted by the VBSS team to fill out a detailed behavior history form. Videos may be submitted by the client or primary veterinarian to behavior@cassvetservice.com. A dropbox link can be provided if the videos are too large for email.

4. Dr. Boas reviews the information provided and provides a detailed written summary of recommendations, including behavior medication options and behavior modification. This summary is typically sent to the primary veterinarian 5-7 days after all documentation is submitted.

5. If the primary veterinarian has additional questions, they are welcome to email Dr. Boas.
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 veterinarian or veterinary clinic:
example@example.com
Name of client:
Client's email address:
example@example.com
Name of patient:
Patient species:

Other
Patient age:
Patient breed:
Patient sex:
Patient's weight in pounds:
What is the presenting complaint?
History and physical exam findings:
Current treatment/medications for behavior problem (please include dose and frequency):
Current treatment/medications for non-behavior concerns (please include dose and frequency):
Previous treatment/medications for behavior concerns (please include dose and frequency):
What are your goals or main questions for this vet-to-vet request?
Additional requests or comments:
Should be Empty:

Vet-to-Vet Request Form