Endoscopy Referral Form

When referring your patient to our hospital, please complete this form along with all pertinent medical records.

 

Which practice would you like to register with?

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REFERRING VETERINARIAN INFORMATION

CLIENT INFORMATION

PATIENT INFORMATION

Type of Endoscopy Requested:





Security Question *

Practice information

Tuxedo Animal Hospital

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  • Mon
    8:00 am - 6:00 pm
  • Tue
    8:00 am - 7:00 pm
  • Wed
    8:00 am - 7:00 pm
  • Thu
    8:00 am - 7:00 pm
  • Fri
    8:00 am - 6:00 pm
  • Sat
    8:00 am - 2:00 pm
  • Sun
    Closed
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Find us here:

192 – 2025 Corydon Avenue Winnipeg, Manitoba, R3P 0N5
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