Boston Veterinary Specialists

Referral Form

Thank you for choosing Boston Veterinary Specialists! Complete your referral form online from any device at any time.

Online Forms

Referral Form

(This form online is not required. You can send us an email instead.)

For your convenience, you may complete the following referral form and submit it through our website. Dr. Briere or one of our team members will be in touch with you as soon as possible. You may also download a PDF to complete and fax, mail, or hand deliver to our office.

Please be sure to attach or fax all pertinent records, reports, and diagnostic images with the pet owner to the appointment. Fax: (781) 326-9782. Email: info@bostonvetspecialists.com

Have a difficult surgery case? Our board-certified surgeons are here to help! Give us a call at 781-326-2140 for a free consultation!

Owner Information

Name *

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Email *

Patient Information

Pet Name *

Gender *

Male
Female

Birthday *

Breed *

Referring Veterinarian Information:

Name *

First

Last

Clinic/ Hospital *

Email *

Phone *

Case Details

Were Radiographs Done?

Date of Last Labwork

Please Upload Records Here or Email to "info@bostonvetspecialists.com", Including Lab Results and X-Rays if Applicable.

Click or drag a file to this area to upload.

Website

Boston Veterinary Specialists

Referral Form

Online Forms

Referral Form

Owner Information

Patient Information

Referring Veterinarian Information:

Your Surgical Specialists in Dedham, MA

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