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Orthopedic Consult Form

Thank you for choosing Viking Veterinary Hospital for your pet’s surgery. Allow us to proceed with your pet’s care by completing our required orthopedic consult form.
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Orthopedic Consult Form

Please fill out this form as completely and accurately as possible so we can best prepare for your pet’s procedure.

Note: This resource should be used in addition to a consultation with your veterinarian.
 This form is not intended to be used as an initial diagnostic or consultation.

Client Information

Patient Information

Referring Veterinarian

Medical Details

File Uploads (Optional but highly recommended)

Drag & Drop Files, Choose Files to Upload You can upload up to 5 files.
Drag & Drop Files, Choose Files to Upload You can upload up to 5 files.

By submitting this form, I hereby give permission for Viking Veterinary Hospital to obtain my pets medical records, including radiographs, from the above veterinary clinic.