Referring veterinarians

Primary care veterinarians throughout Connecticut and the surrounding states refer their veterinary dermatology cases to us. Please use this form to refer a patient to us. We are also happy to offer other veterinarians answers to questions about your cases. Please email your questions to info@unleashedvetderm.com.

Referring Veterinarian name

Referring Veterinarian Email

Referring Veterinarian Phone #

Contact preference

Email Phone

Owner name

Owner email

Owner phone #

Is this an emergency?

Yes No

Pet name

Dog Cat

Reason for referral

Relevant history, non-dermatologic

Relevant laboratory tests performed (ie, biopsy performed and date, culture performed and date-- no need to list specific results as long as records are attached)

Current medications

Past medications

Recommendations for handling (e.g. muzzle, sedation)

Please upload relevant medical records. If you don't want to upload them here, our office will be happy to contact yours to obtain them.

Referring veterinarians

Quick Links

More Quick links

Hours

Contact us

Phone

Stratford, CT

Schedule

Pharmacy