Referral Form
A referral is REQUIRED from practicing veterinarians. Please download, complete and return the form. Referral forms can be found on our Veterinary Resources page.
- Filling out the referral form – The referral form must be completed in its entirety. Incomplete referral forms will not be accepted and will delay the referral process. Here are some additional instructions and information to consider:
- We communicate appointment scheduling primarily via phone and email. Booking notifications along with important pre-visit instructions are sent via email to the client prior to the visit. Appointment reminders are sent via text to clients who are opted in generally 3-5 days before the scheduled appointment. Please make every effort to include a valid client email address and cell phone number on the referral form.
- The Reason for Referral and Pertinent History sections on the general small animal referral form must contain a brief summary. The phrases “see attached”, “see history” or similar phrases will not be accepted and referrals will be returned to the referring veterinarian to complete. This information is required to properly and efficiently schedule the appointment.
- There are designated sections for you to check if lab testing and/or radiographs were performed. Please complete these sections and let us know how we can expect to receive copies.
- Indicate in the bottom right-hand corner of the referral form what service you are referring to. If you are not sure, please call and discuss the case with the referral coordinator prior to sending us the form. If the client arrives and it is determined the patient was referred to the incorrect service, their visit will have to be rescheduled for the first available appointment with the appropriate service. We cannot guarantee the appropriate service can evaluate the patient that same day. Multiple service referrals may not be able to be accommodated on the same day. Please inform your client that they may need to return for additional appointments.
- Referral forms and pertinent medical history should be sent at least 48 business hours before the patient’s appointment at UTCVM.
- Emailed referral forms and medical records are preferred due to unreliability of fax transmissions.
- Questions? Reach out to the referral coordinators by phone 865-974-3939 or email utvetref@utk.edu
Pertinent medical history and diagnostic imaging
In addition to the Referral form, please include:
- Case history, including pertinent medical records from previous six months to one year. Please do not send the entire medical record.
- If you are sending medical records digitally, please combine all pages into ONE PDF before attaching to an email. We cannot accept emails with numerous attachments (no more than three). You can learn how to combine PDFs into one file here. This does not pertain to radiographs/images. We also cannot accept numerous emails or zipped files. It is best for the history to arrive on the same email as the referral. Most veterinary medical records software programs allow for medical records to be combined into one PDF document by date range. Please contact your medical records software company for technical assistance. All documents should be attachments and not embedded in the body of the email. If you cannot combine the documents, please fax or mail them instead. If you have questions, please reach out to us.
- Current list of medications
- Current lab work from the previous 6 months to one year.
- Most current vaccination record for proof of vaccine and aid in diagnosis
- Previous surgeries related to admitting complaint
- Radiographs and imaging (refer to #4 below)
Submit the referral form and pertinent medical history
- Email vetclientservices@utk.edu
- Or mail to:
UTCVM Veterinary Medical Center
Attn: Appointment Desk
2407 River Drive
Knoxville, TN 37996-4546
Diagnostic images and imaging reports
- Images should pertain to admitting complaint. If anesthesia is required and you have performed recent chest radiographs, please submit those as well.
- All images should be in DICOM format as Bitmap, JPEG, and TIFF images are not of digital quality and will not be accepted. Please send original images and not photographs or screenshots.
- Radiographs and/or images are best sent directly to our picture archiving and communication system (PACS) or emailed to vetclientservices@utk.edu.
- You may request our PACS connection information via phone or email. Image submissions are not for radiographic interpretation and should only be submitted as part of a case consultation or referral. Please include the name of the pet, client, date or exams and pertinent information for all imaging submitted.
- Google Drive links and UT Vault messages cannot be retrieved when sent to vetclientservices@utk.edu. Large files can be shared via PACS or sent to a personal email via the UT Vault- https://vault.utk.edu/. Please contact the Image Facilitator for further instructions. This video explains how to send images via the UT Vault.
Films or CD’s may be mailed to:
UTCVM – Small Animal Clinical Sciences Attn: Radiology
2407 River Drive C247
Knoxville, TN 37996-4544
If you need copies of your patient’s diagnostic images or have questions, please reach out to our Image Facilitator by phone at 865-974-2223, Radiology at 865-974-5809 or by emailing vetclientservices@utk.edu.
