HALE VETERINARY CLINIC
DENTAL AND ORAL SURGERY FOR PETS

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FORMS & HANDOUTS
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This page offers pdf versions of several useful forms for referring veterinarians.

You will need Adobe Acrobat Reader to open these files. If you do not have this program, you can download a free version by clicking here.
Referral Forms and Information

These forms are intended make arranging a referral as easy as possible.

Fillable pdf Referral Request Form: This form asks the questions I need answers to before seeing your patient. The more pertinent information you give me, the better I can serve your client and patient

Open the file by clicking on the link above and type  the information into the fields (or cut and paste from your electronic patient records). Click 'file' then 'save as' to save the filled form to your patient record or where ever. Then send the saved form to us as an attachment to an email. Now you have a copy and we have a copy and everyone can read it because there is no doctor's hand writing anywhere to be seen.

Fax Referral Request Form: This is the same form as above that you can print out, fill in by hand (legibly please) and fax to us.

What to Expect: When you have seen a problem that you think requires my attention, give this sheet to your client. It will explain what is involved in bringing their pet to see me.

Referring veterinarians are encouraged to read this paper that outlines what I need you to do and what you can expect me to do. 

Client Education Handouts:

You are welcome to download and distribute these informative sheets to your clients. I ask that you respect my authorship and use them "as is". 

These one-page, pdf documents are very introductory. There is a great deal more detailed information on all of these subjects and more on the Old CUSP Articles page.

 

The Knee Cap Rule: Give this handout to ALL dog owners to help reduce the needless and preventable damage to teeth.

Dental Home Care for Dogs and Cats: What is the goal of home dental care and why must it be paired with regular professional dental care?

Periodontal Disease is Hidden: What we see in the crowns of the teeth often has no relationship to the level of periodontal disease. In order to properly evaluate periodontal disease, we must anesthetize your pet for a detailed clinical and radiographic evaluation.

Pulp Exposure in Dogs and Cats: What happens to teeth that are worn or fractured to expose the pulp tissue inside?

Dentin Exposure in Dogs and Cat: What happens to teeth that are worn or fractured through the thin layer of enamel to expose the porous dentin?

Feline Chronic Gingivo-Stomatitis: A brief discussion of a very complex, painful and frustrating condition seen commonly in cats.

Tooth Resorption in Cats: A brief discussion of a poorly understood, painful and common dental condition in cats.

Tooth Resorption in Dogs: A brief discussion of a poorly understood, painful and common dental condition in dogs

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Consents and Waivers

These are samples of some of the consent and waiver forms I use, just FYI.

Who Does What: Clients are asked to review this paper on arrival in accordance with the College of Veterinarians guidelines on Informed Owner Consent.

Estimate and Consent: Each client (even my own mother) must sign a surgical consent form before I start any treatment.

Orthodontic Waiver: Correcting orthodontic problems in dogs and cats involves some cloudy ethical issues.

Disarming Waiver: Dogs and cats that bite can be made less dangerous by having their canine teeth shortened (followed by direct pulp capping) or extracted. Clients need to know and acknowledge that these procedures do not make the animal harmless, not does having this work done reduce the owner's liability and responsibility.

Other Forms These dental charts were developed by members of the American Veterinary Dental College and are being shared for your (non-commercial) use.

Dog_Deciduous_Chart

Dog_Deciduous_Rad_Findings

Dog_Chart

Dog_Rad_Findings

Cat_Deciduous_Chart

Cat_Deciduous_Rad_Findings

Cat_Chart

Cat_Rad_Findings

Abbreviations and Codes: This sheet defines the abbreviations and scoring I use in my dental records.


20pixelgif.gif (808 bytes)Services ] Referrals ] A Visit ] Frequently Asked Questions ] Virtual Tour ] Staff ] Map to Office ] Dental Care for Pets ] [ Forms & Handouts ] News ] Continuing Ed. ] Old CUSP Articles ] Book ] Contacts ] Links ]
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