ACCESS | Advanced Critical Care, Emergency and Specialty ...
[Pages:2]ACCESS | Advanced Critical Care, Emergency and Specialty Services
Patient Referral Form
Date:
For Attention:
ACCESS | South Bay
ACCESS | Los Angeles
ACCESS | San Fernando Valley
Patient Name: Client Name: Dr. Name: Practice Name: Laboratory Name:
Dog Cat Other
Dr. Tel #: Dr. Fax #: Account #:
How would you like to be contacted? Tel:
Fax:
Mail:
Email:
Please include copies of lab reports, X-rays, and other diagnostics. Patient History
Diagnostics
Treatments / Medications
Referral Request As the referring veterinarian, my expectations for this case are as follows: (Please check one.)
Referral for the following procedure(s): Hospitalization and definitive care. Overall management of care for the diagnosis of: Overnight care and return in the morning.
Client Notice: Please bring this form, your pet, and all medications to your initial consultation. Please ask your veterinarian if you need to withhold food or water from your pet before your appointment.
Page 1 of 2
ACCESS-Referral-Form-v14
ACCESS | Advanced Critical Care, Emergency and Specialty Services
Patient Referral Form
Client Information / What to expect...
HOW WE WORK WITH YOUR VETERINARIAN
When your pet is sick or injured, treatment usually begins with your local veterinarian ? a skilled and highly trained doctor. Occasionally, their patients (your pets) require specialized care.
This is where ACCESS comes in! Advanced Critical Care, Emergency and Specialty Services provides advanced medical treatment and cutting-edge technology to vets and information to vets and pet owners.
Our departments include Avian & Exotics, The Bone & Joint Center, Emergency & Critical Care, Cardiology, Internal Medicine, Interventional Radiology & Endoscopy, Nephrology, Neurology & Neurosurgery, Radiology, Surgery, Urology, and Counseling.
OUR PLEDGE TO PET OWNERS To always care for your pet as we would care for our own. To be empathetic, compassionate, courteous, and respectful. To provide your pet with the ideal treatment plan, and to always consult with you, or your vet, if other services or treatments are required. To provide accurate reports to your vet in a timely manner. To respect your relationship with us as a client, and recognize that your needs and concerns are important. To be at the forefront of veterinary care.
Crenshaw Blvd. Van Ness Ave.
Je erson BlvdD.uquesne Ave
LOCATIONS
Exit 39
W 182nd St Exit 39
405
186th St Exit 38B
W 190th St
Torrance
213
W 190th St
N
South Bay
2551 W. 190th St. Torrance, CA 90504 Tel: (310) 320-8300 Fax: (424) 293-7254
24x7 Emergency & Specialty Services
Exit 6
10
Venice Blvd.
187 405
Exit 50B
90
Culver City
Exit 50B
N
Los Angeles
9599 Je erson Blvd. Culver City, CA 90232 Tel: (310) 558-6100 Fax: (310) 558-6199
24x7 Emergency & Specialty Services
Winnetka Ave Exit 25
101
Exit 25
Ventura Blvd.
Woodland Hills
Winnetka Ave
N
San Fernando Valley
20051 Ventura Blvd. Woodland Hills, CA 91364 Tel: (818) 887-2262 Fax: (818) 704-0323
24x7 Emergency & Specialty Services
OUR MISSION To provide exceptional specialty veterinary care where pet owners and primary veterinarians have ACCESS to cutting-edge medicine with the best doctors and support sta in a warm, family environment.
OUR PRINCIPLES Quality | Integrity | Compassion | Service
QUESTIONS AND SUPPORT Should you have any questions about our services, please do not hesitate to contact us at: Email: info@ |
EMOPERENGEFNOCRIES*
Owned by veterinarians. Loved by animals.
Page 2 of 2
ACCESS-Referral-Form-v14
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related searches
- critical care nurse job description on resume
- espen critical care nutrition guidelines
- critical care tech
- critical care tech job description
- critical care intensivist job description
- critical care technician job description
- critical care technician description
- critical care physician jobs
- critical care doctor job description
- critical care registered nurse resume
- critical care physician job description
- critical care intensivist salary