Please complete this form and return it along with all radiographs, bloodwork results and medical history within 48 hours of receipt to [email protected]. Please Note: The following vaccinations and diagnostics are required to be current for all non-emergency dental procedures: 
Canines: Rabies, DHPP and a negative heartworm test. 
Felines: Rabies and FVRCP
Is this an urgent referral?
Any known allergies, drug reactions or sensitivities?