Referring Vets • Referral Form
Referring Vets

Referring Vets

We know that entrusting your patients to another doctor is a serious responsibility. At WVERC, we want you to know that your referred patients will receive only the best care from us.

You always can count on us to be your partners in health care. and have a full range of services and specialists to meet the needs presented by even your most challenging cases.

Feel free to contact us for a tour of our facility and to meet some of our staff.

Please fill out the form below for all other referrals to Westford Veterinary Emergency Referral Center.
The form will be emailed to us upon submission.

If you prefer, download and print our WVERC Referral Form (PDF), and FAX it to (978) 577-6463.

Referral Form

Client Information

Client First Name

Client Last Name

Phone Number

Patient Information

Pet's Name

Species

Gender

Age

Is pet spayed/neutered?

Referring Veterinarian

Referring Hospital/Clinic

Department You Wish to Refer

Diagnostic Imaging Requested

Working Diagnosis/Concerns

Please list any recent diagnostics performed

Please list current medications or treatments

Please forward all pertinent medical record information including results of laboratory tests via fax or e-mail. Digital radiographs can be e‐mailed if possible as well. This allows our staff to review details of the case prior to the appointment to help us offer the highest quality patient care and client service. Additional copies of the record and/or x-ray films may be sent with the client on the day of the appointment. We are here to help, so please feel free to call us directly with any questions!

Please have client call us to schedule an appointment with our specialists.

Would you like our staff to contact your client directly to schedule an appointment?