INTERNAL MEDICINE CONSULT REFERRAL FORM

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Hans Gelens, D.V.M., Diplomate ACVIM (Small Animal Internal Medicine)
Board -Certified Small Animal Internal Medicine Specialist.

Appointments are booked on average 2-4 weeks in advance, always on a Tuesday.

There are no emergency appointments in internal medicine but if there are urgent cases then please contact the Fairfield Animal Hospital (250) 860 6550.

Thank you for your referral!

To submit a referral please fill out the form below and hit SUBMIT when finished.

Email *

Is this case URGENT? IF so PLEASE call Fairfield Animal Hospital 250-860-6550 to check availability PRIOR to submitting referral *

Yes

The client must be made aware by the referring veterinarian that the first appointment costs $431.25 + tax, and will be an initial exam and consultation ONLY. Scoping, Ultrasound, etc would be scheduled for a later date.

1) Has the owner been informed of this?

2) Please ensure the client has committed to going forward with the appointment before sending in a referral.

Yes

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