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(916) 584-1635
hello@chiwestvet.com
facebook

Home
About Us
- Our Team
- Testimonials
Services
Resources
Dr. Koh’s Favorites
Contact
Request Appointment

Referrals Form

Thank you for choosing Chi West Veterinary Rehabilitation and Integrative Health for your client’s care. To begin your referral to us, please complete our online referrals form.

Referrals Form

Please fill out this form as completely and accurately as possible so we can most easily streamline the referral process.

Date *

Veterinarian Name *

First

Last

Practice Name *

Laboratory Name

Veterinarian E-mail *

Veterinarian Phone *

Veterinarian Fax

How would you like to be contacted?

Phone
Email
Fax

Client Name *

First

Last

Patient Name *

First

Last

Patient Species *

Dog
Cat
Other

Please upload lab reports, x-rays, and other diagnostics.

Click or drag a file to this area to upload.

Additional Upload (if necessary)

Click or drag a file to this area to upload.

Additional Upload (if necessary)

Click or drag a file to this area to upload.

Additional Upload (if necessary)

Click or drag a file to this area to upload.

Patient History

Diagnostic Information

Treatments / Medications

As the referring veterinarian, my expectations for this case are as follows: (Please check one.)

Evaluation of lameness or pain
Referral for specific therapy or procedure(s) (e.g., rehabilitation, acupuncture, manual therapy, therapeutic exercises, laser therapy, regenerative medicine)
Referral for integrative medicine
Referral for hospice and palliative care
Ongoing rehabilitation and integrative medicine care

Is there any more information we should know?

Name

Chi West Veterinary Rehabilitation and Integrative Health Favicon

Ready to Schedule an Appointment?

No matter where you’re located—whether in Greater Sacramento, Roseville, Arden-Arcade, or the Bay Area, including San Francisco, San Jose, and Oakland—our mobile services are here to provide your pets with the highest standard of care.

We proudly offer a combination of mobile services, in-clinic care, and telemedicine consultations to meet your needs. For in-clinic appointments, Dr. Koh is available on select days each month at leading rehabilitation, holistic, and specialty hospitals in Davis, Oakland, and Roseville. Telemedicine appointments are accessible not only for pet owners in California but also for those in other states and countries.

Contact us today to learn more and schedule an appointment—because your pet deserves the very best care, wherever you are!

Request Appointment

Have a Question?

Please complete our online form and a member of our team will get back to you as quickly as possible.

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Mobile Location

Serving Greater Sacramento, CA, and the surrounding areas

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Get in Touch

Phone: (916) 584-1635
Email: hello@chiwestvet.com

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Hours

Mon – Fri: 8:00 AM – 5:00 PM
Sat – Sun: Closed

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