Patient Info Form | SE Vet Cardiology

Use this form to add patients to your previously scheduled appointments

up to 4 cases per appointment booked via online scheduler
- email info@sevetcardiology if additional cases (5+) are desired
if work-in appointment, check with SEVC before adding additional cases
A confirmation email will be sent to the address entered. If not received please resubmit or contact SEVC.

SUBMITTING A PATIENT INFO FORM ALONE DOES NOT RESERVE AN APPOINTMENT WITH SEVC

use "Schedule Consultation" page to book an appointment BEFORE filling out patient info forms

**Please note, at this time SEVC is not performing mobile echocardiograms on fractious dogs >70 pounds. Please refer to a traditional cardiology service if your large breed patient requires special handling**

These forms should be filled out by the veterinarian or a medically-trained staff member who knows details about each case.

All pertinent information to the consultation must be written on the patient info form.
DO NOT WRITE "See Records/Records Attached" or "ask DVM".
If no/limited/incorrect information is provided, SEVC's recommendations may be inaccurate.
If desired, pertinent records can be also be attached or emailed to: referrals@sevetcardiology.com.
Attached/emailed records may not be extensively reviewed, so please include all relevant information inside the patient info form.

Email info@sevetcardiology.com with any questions

ADDITIONAL INFO: Keep track internally (on your clinic's own schedule) of what patients are scheduled for each appointment. Each clinic is responsible for scheduling/confirming dates with clients. Please consider taking deposits to limit cancellations. Patient info submissions are required - otherwise your appointment may be cancelled or case time given to other clinics if it appears to SEVC that no patients are scheduled. If a change in medication dosing or clinical signs/condition occurs after submitting the info form, please update SEVC - otherwise we will not know about these changes Please note that the online scheduler and patient info forms are separate. The online scheduler creates the time reservation only - it is not involved with patient submission. The patient info form is just to provide information for each patient you wish SEVC to evaluate during the reserved time. ***Email will be the primary method used to confirm/adjust consultations - please include a monitored, general clinic email address to prevent delays.*** See information about travel and cancellation fees on the scheduler page (at bottom) Any records can be submitted using the link below the patient info form or by emailing them to referrals@sevetcardiology.com

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