Refer a Case – A Loyal Companion

4758 E. Grant Road

Tucson, AZ 857125

Email: [email protected]

Phone/SMS: 520-448-3548 Fax: 520-457-5828

Canine Mobility Solutions

Thanks for your referral to A Loyal Companion!
We value your referrals and welcome any specific questions regarding our mobility solutions.

Veterinary Referral Request

Client Information
Name*
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Address
Street Address Address Line 2 ZIP Code
Phone*
Email
Animal Information
Pet Name*
Species
DOB/Age:
Sex
Breed
Laterality
Veterinary Information
Practice Name*
Veterinarian Name*
Vet Phone*
Vet Fax
Vet Email
Case Information
Diagnosis*
Pertinent Medical History*
Therapeutic Goals of Device*
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If I have specific questions regarding the mobility solutions I am referring, I will contact A Loyal Companion directly for assistance
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Many mobility solutions listed on the following pages require a veterinary referral. A Loyal Companion does not provide veterinary services or diagnose conditions. Our role is to work with your veterinarian to identify the best solution for your dog’s mobility issue and your household situation.

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We value your feedback and interaction. Please reach out anytime!

Tucson, Arizona

4758 E. Grant Road
Email Us
520-448-3548

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