8650 W. Tropicana Avenue, Ste. B-107, Las Vegas, NV 89147

Reopening Soon!
North Rainbow Veterinary Emergency Hospital
4445 North Rainbow Blvd, Craig & Rainbow, Las Vegas, NV 89108

Phone: 702-871-1152

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For Pet Owners
for Veterinarians
Prescription Refills
Online Payments
Contact Us

for Veterinarians

Prescription Refills

Online Payments

Referral Form

Referral Form

Select Department:
- Surgery
- Ophthalmology
- Cardiology
- Oncology
- Internal Medicine
- Animal Rehabilitation
- Neurology
- Emergency/Critical
Referred By Dr.
Referring Hospital
Hospital Address
Street Address Address Line 2 City State ZIP Code
Hospital Phone
Fax
Your Email
How would you like to be contacted
- Phone
- Fax
- Email
- Mail
Did you Fax
- Pertinent Medical Records
- Blood Work
- Histopathology
- Ultrasound Reports
- Send Rads w/ client
Did you tell Client
- No food after 10 pm
- H2O is OK
- Bring Rads from RDVM
- Bring all current medications
Name of Client
Address
Street Address Address Line 2 City State ZIP Code
Phone
Patient's Name
Species
Breed
Sex
- F
- SF
- M
- CM
- Unknown
Age
Color
Tentative Diagnosis/Chief Complaint:
History/Physical Findings:
Most Recent Vaccination (date & type)
Treatments (Include medications and dosages)
Laboratory Data (Attach copies of results)
Drop files here or

Max. file size: 256 MB.
Special Request/Comments:
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Las Vegas Veterinary Specialty Center | 8650 W. Tropicana Avenue, Ste. B-107 | Las Vegas, NV 89147
Phone: 702-871-1152, Fax: 702-262-7000
Copyright 2015 Las Vegas Veterinary Specialty Center - Las Vegas Veterinarians.

Copyright (c) Las Vegas Veterinary Specialty Center 2013. All text, images, photographs and other materials contained or displayed on this site are wholly owned by and are proprietary to Las Vegas Veterinary Specialty Center and constitute valuable intellectual property. No materials from any part of this site are authorized or intended to be downloaded, transmitted, broadcast, reproduced or in any other way used or otherwise disseminated in any form to any person or entity, unless said person or entity has an express, prior written license to do so. All unauthorized duplication or any other use of materials from this site shall constitute intentional infringement(s) of Las Vegas Veterinary Specialty Center intellectual property and shall further constitute a violation of our trademarks, copyrights, and other rights. Without further notice we will prosecute to the fullest extent allowed by civil and criminal law.

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