Animal Emergency Care Of Braselton
Transfer Form
Transferring Doctor Name
*
First Name
Last Name
Veterinary Hospital
*
After Hours phone number for any questions related to patient care:
Owner's Name
*
First Name
Last Name
Owner's Phone Number:
Patient's Name
*
Species, Breed, Age, Sex
History:
Diagnostics performed and results: Please send copy of any lab results or radiographs with owner or upload below.
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of
IV Fluids: type, rate, amount given
Medications: Type, amount, route, time given
Surgery: Procedure, findings, time completed, anesthetic recovery
Any additional information:
Any labs or treatment you wish to be performed while at AECOB:
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