Submit a Referral

For vet clinics and veterinarians needing to submit a referral, please fill out the form below. If you have any questions or need to send additional details please email info@borealanimalsurgery.com

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This field is for validation purposes and should be left unchanged.

Client's Name(Required)

Client Phone Number(Required)

Client Email Address

Pet's Name(Required)

Pet's Age(Required)

Pet's Breed(Required)

Reason for Referral(Required)

Species(Required)

Medications(Required)

Imaging or Medical Records Attach or Email to hello@basvet.com

Max. file size: 50 MB.

Urgency Level(Required)

Has the Client Been Informed of this Referral?(Required)

Relevant History / Clinical Notes(Required)

Referring Veterinarian(Required)

Clinic Name(Required)

Preferred Method of Contact

Clinic Phone Number(Required)

Clinic Email Address(Required)