Referral Forms

We'd love your input.

Button - What's on your mind?If you’ve got something specific on your mind, click on the link above to drop us an email, and we’ll get back to you as soon as possible.

Or, if you’ve got a minute or two to spare (trust us, this won’t hurt a bit) we’d be more than grateful if you could fill out our brief Veterinarian Questionnaire, to help us stay on top of all of things that matter most to you.

Vet Questionairre IconWe’re always striving to be as good as we can be for our referring veterinarian partners, which is why we’re always open to your thoughts, ideas, criticisms and comments. Just click on the link above to get started.

Pick a form, any form.

ASG RDVM General Referral FormASG RDVM Ultrasound Referral FormASG RDVM CT Referral FormASG RDVM Rehabilitation Referral Form

When you’re ready to refer a case, we’re ready to help you. And for your convenience, our referral forms are available for download.

Choose from the list of referral forms above, and return completed forms, along with any corresponding medical records, to our office using your preferred method of delivery. Referral information may be mailed, sent with the client, or sent via fax. If using the mail please allow enough time for the information to arrive so it is available at the time of the consultation. Phone consults are welcome and encouraged.

Please have the client call us to make an appointment.

Return your form to us by:

MAIL: Animal Specialty Group
4641 Colorado Boulevard
Los Angeles, CA 90039
TEL: (818) 244-7977
FAX: (818) 507-9418


Form descriptions

General Referral Form: Internal medicine, surgery, neurology and oncology referrals should be made with this form. Please make certain to send Animal Specialty Group the most recent history of your patient including copies of lab work and any radiographs (either on CD or actual film). It is preferred to receive these items along with the referral form prior to the client appointment.

Outpatient Ultrasound: When you need a piece of your diagnostic puzzle solved, but do not have the need for the case to be managed by one of our specialists, this is the form to use. Animal Specialty Group’s board-certified radiologist will assist you in finding the answers to establish a diagnosis. Please note that all client communications will be the responsibility of the referring veterinarian. Our board-certified radiologist does not consult with your client but will fax you the ultrasound report following the examination enabling the referring veterinarian to continue management of the case.

Outpatient Computed Tomography (CT): Another advanced diagnostic tool we offer to our referring veterinarians is our outpatient CT. Copies of the CT images will be given to the client for the referring veterinarian’s review. A formal CT report (by a board-certified radiologist) will be faxed to the referring veterinarian the following day. Please inform the client that the CT findings and any additional plans will be discussed with them by the referring veterinarian.

Physical Rehabilitation and Integrative Medicine Services: This is the form to be used when referring patients for services such as acupuncture, holistic medicine, underwater treadmill and other alternative medicines (see Our Specialists page for a full list of our rehabilitation services). As with all of Animal Specialty Group referrals, we request that you provide us with as full a history as possible including radiographs and lab work prior to the client’s appointment.