rDVM Referral Form

Warning: Use of undefined constant MCRYPT_RIJNDAEL_128 - assumed 'MCRYPT_RIJNDAEL_128' (this will throw an Error in a future version of PHP) in /home/veteri59/public_html/wp-content/plugins/gravityforms/includes/fields/class-gf-field-captcha.php on line 371

We want to make referral easy for you and your staff. To refer a case to Veterinary Rehabilitation and Arthritis Center, simply fill out the online referral form below, or download the form as a PDF and send it to us. If you wish to speak with our clinic regarding the case prior to referring it to us, please just give us a call at 603-782-5070 and we would be happy to assist you!

Important Note: Whether you use the online form or the PDF form, please also send/scan a copy of the patient record including all recent bloodwork and imaging. Please send analog radiographs with the client. We will be sure they are returned.

PDF Form

rDVM Referral Form – click this link if you would like to download the form in PDF format, print, and complete.
Return by Email: You can scan the completed form and attach to an email sent to
Return by Fax: You can fax the completed PDF to 603-215-2888.
Return by Regular Mail: You can mail the completed form to:
Veterinary Rehabilitation and Arthritis Center
1123 Hooksett Road (Rte. 3)
Hooksett, NH 03106


If you prefer, complete the online form below. All the information will be sent to us immediately and you will receive an email confirmation as well.

  • Referring Veterinarian Information

  • Client Information

  • Patient Information

© 2018 VETERINARY REHABILITATION & ARTHRITIS CENTER   |   1123 Hooksett Road, Rte. 3 Hooksett, NH 03106
Phone 603-782-5070   |   Fax 603-215-2888   |