Monday-Friday 8:00AM - 6:00PM

Rehabilitation Referral Form

Download and Print Form
  • Please provide a copy of relevant and comprehensive medical history, diagnostic imaging (if applicable), and treatment(s) since injury/surgery.
  • Vaccine history
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Missed Physical Rehabilitation Appointment Policy

  • At Cary Street Veterinary Hospital our goal is to provide the best in veterinary care for your pet. Physical rehabilitation appointments are in high demand and when they are missed, we lose that opportunity to offer timely medical care to a patient in need. In order to be respectful of the medical needs of all or our patients, we ask that you keep your appointments, arrive on time, and that you notify us at least 24 hours in advance if you will be unable to make your scheduled appointment.

    Arriving 15 minutes late without notice and late cancellations will also be considered a missed appointment.

    1st missed appointment - Our staff will call to ensure the wellbeing of you and your pet in addition to rescheduling your appointment.

    2nd missed appointment - We will call you to let you know that this is your second missed appointment and you will be responsible for paying the missed appointment fee of $100.

    3rd missed appointment - We will call you to let you know that this is your third missed appointment and you will be responsible for paying the missed appointment fee of $100. Additionally, all future appointments will require pre payment in order to schedule an appointment.

  • Date Format: MM slash DD slash YYYY