Veterinarian Teleconsulting Form
SUBMITTED BY YOUR PET’S PRIMARY DVM ONLY
This form is required to be filled out by the RDVM for ALL owner's wanting a teleconsultation prior to scheduling an appointment.
The Veterinary Psychiatric and Behavior Center is currently offering enhanced veterinary teleconsultations for referring veterinarians and their patients in need of behavioral care.
Prior to scheduling a teleconsultation with your client, we will need you to attest to the physical health of the patient and provide details of a recent physical examination and diagnostics. A complete blood count, chemistry panel, T4, and urinalysis are strongly encouraged but not required if collection of diagnostics presents a danger to the patient or your veterinary team.
You, as the referring veterinarian, will be asked to prescribe and make medication changes in consultation with Dr. Tucker throughout the patient's follow-up period.
Appointments are conducted via Zoom conferencing and will be held between Dr. Tucker and the client. You will also receive an invitation to the consultation and you are encouraged to attend if possible.
Appointments typically last 1 hour and include a review of the patient's behavioral and medical history, observation of the pet's behavior via video, and discussion of behavioral and medical therapy options.
A written summary of the appointment and treatment recommendations will be emailed to the client and you, the referring veterinarian.
Changes to the treatment plan can be made by email communication for a 2 month follow-up period after the appointment, as long as you, the referring veterinarian, are involved in all communications and will take responsibility for any recommended medication changes.
After the 2-month follow-up period, any changes will require a follow-up consultation. There will be NO phone call consultation between the client and Dr. Tucker after the initial appointment due to the need for a valid veterinarian-client-patient relationship.
All follow-up contact between the client and Dr. Tucker must be conducted through email with the referring veterinarian copied.
Health history is a crucial part of our assessment and influences our treatment recommendations; therefore appointments are only scheduled after we receive complete medical records from your office, behavior questionnaire appropriate for the species, and payment for the appointment.
In addition to results from a recent physical examination and diagnostics, we ask that you submit full medical records including notes on physical exam findings and copies of diagnostic test results.
Payment information and questionnaire forms can be found on The Veterinary Psychiatric and Behavior Center PLLC website. All payment is collected through an online secure site. Mail-in checks or cash payments are not currently accepted. If the species you are referring to us does not have a current behavior questionnaire form on the VPBC website, then please email to request a form unique for your species.
Please fill out and sign below, affirming that you have a valid veterinarian-client-patient relationship and are willing to prescribe and make medication changes for this patient in consultation with Dr. Tucker.