TPLO Referral - Fleetwood Veterinary Clinic - Surrey, BC

Fleetwood Veterinary Clinic

#106 - 17670 65A Avenue
Surrey, BC V3S 5N4

(604)576-6640

www.fleetwoodvet.ca

TPLO Surgery Referral Request

Please fill out and submit the online form below.

We also have a downloadable form you can print and fill out if so preferred. 

TPLO Referral Form

Date of referral: (required)

Client & Patient Information
Client Name: (required)

Patient Name: (required)

Client Home Phone:

Client Work/Cell Phone:

Species: (required)

Breed: (required)

Age/DOB: (required)

Veterinarian Information
Referring Hospital: (required)

Veterinarian: (required)

Phone: (required)

After-hours Phone:

Fax:

Email: (required)

Priority: (required)
Next available
Urgent
Reason for Referral: (required)

History: (required)

Clinical Signs: (required)

Relevant Clinical Pathology data: (required)

Current Treatments: (required)

Radiographs: (required)
not done
coming with owner
emailed
Special Requests:


Verify the reCAPTCHA:




Fleetwood Veterinary Clinic

#106 - 17670 65A Avenue

Surrey, BC V3S 5N4

Phone: 604-576-6640

Email: contact@fleetwoodvet.ca

HOURS

Monday

8:00 AM - 8:00 PM

Tuesday 

8:00 AM - 5:00 PM

Wednesday

8:30 AM - 5:00 PM

Thursday

8:00 AM - 8:00 PM

Friday

8:00 AM - 8:00 PM

Saturday

Closed

Sunday and Stat holidays

 Closed

 

SERVICE AREA

Cloverdale, Langley, Surrey, New Westminster, White Rock, South Surrey, Vancouver, Coquitlam and beyond!

SOCIAL

 

facebook icon instagram icon

Group of animals

Fleetwood Veterinary Clinic

#106 - 17670 65A Avenue

Surrey, BC V3S 5N4

Phone: 604-576-6640

Email: contact@fleetwoodvet.ca

HOURS

Monday

8:00 AM - 8:00 PM

Tuesday 

8:00 AM - 5:00 PM

Wednesday

8:30 AM - 5:00 PM

Thursday

8:00 AM - 8:00 PM

Friday

8:00 AM - 8:00 PM

Saturday

Closed

Sunday and Stat holidays

 Closed

 

SERVICE AREA

Cloverdale, Langley, Surrey, New Westminster, White Rock, South Surrey, Vancouver, Coquitlam and beyond!

SOCIAL

 

facebook icon instagram icon

Group of animals