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Please use this form to submit a referral request to the Behavioral Medicine Service.

This service is for veterinarians only – clients seeking medical information should contact their regular veterinarian for assistance or go to www.ncsubehavior.com for more information.

If you would like to make a referral to the Behavioral Medicine Service and you do not need to talk to a clinician, you can use this form to submit the client and patient information. Please indicate on the form under “Client Contact” if you have asked the client to call the Behavioral Medicine Service, or if you would like us to call the client. Please provide a brief summary of the patient’s problem and send supporting documents (lab results, chart notes) via e-mail (ncstatevetbehavior@ncsu.edu) or fax (919-513-6905). After we see the client and patient is our office, we will send to you a detailed discharge summary.

 

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Veterinarian Contact Information

Owner Contact Information

Patient Information