Internal Medicine Referral Form

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Please contact Capital City Specialty & Emergency Animal Hospital at (613) 244-7387 if you need assistance with any referral.

If the attachments surpass the maximum 50MB file size, please email the patient’s records and imaging directly to internalmedicine@capcityvet.com.

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REFERRING VETERINARIAN INFORMATION

PATIENT INFORMATION

FILES

Please include all documents which are relevant to the presenting complaint here.

The following files are attached:

Max. file size: 50 MB.
Max. file size: 50 MB.
Max. file size: 50 MB.
Max. file size: 50 MB.
Max. file size: 50 MB.
Max. file size: 50 MB.
0 of 5000 max characters