2 Continental Drive, Exeter, NH 03833 | Mon - Fri 8:00 AM - 5:00 PM | Ph: (603) 519-4160

2 Continental Drive, Exeter, NH 03833 | Mon - Fri 8:00 AM - 5:00 PM | Ph: (603) 519-4160

Request Appointment (603) 519-4160

Integrative & Holistic Referral Form

Please fill out the form below and one of our team members will reach out to schedule your appointment.

"*" indicates required fields

Referring Veterinary Information:

Clinic Address*
Communication Preference

Referring Veterinary Information:

Client / Owner name*
Client Address

Pet Information

Referral Information:

**Please attach all pertinent patient medical records. ** Please send all medical records and diagnostic test results and x-rays 48hours before the scheduled appointment. This will give us time to thoroughly review them and allow us to better assist your client in providing the most beneficial integrative diagnostics and treatments.

Diagnostic Testing

Has diagnostic testing been performed in the last 30 days?*
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    Max. file size: 128 MB.
      Integrative / holistic services requested (Please select all that apply):

      *** Regarding selected and desired treatments: While every effort will be made to provide the specific treatment requested by the client and the referring veterinarian, the specific treatment protocol will be chosen based on the patient’s history, integrative exam and diagnostics, specific needs of the pet, and the ability of the client / owner to follow through with treatments.

      We look forward to working with you and your client to provide their pets the best integrative and holistic veterinary care available. Working together we can provide a balanced treatment plan combining the best of both aspects of veterinary care. Thank you for your trust and your referral.