Refer a Case - A Loyal Companion

4758 E. Grant Road

Tucson, AZ 857125

Email: info@aloyalcompanion.com

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*
First Last
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*
Records Upload
Drop files here or

Accepted file types: pdf, Max. file size: 10 MB.
Consent
This information has been completed to the best of my knowledge.
If I have specific questions regarding the mobility solutions I am referring, I will contact A Loyal Companion directly for assistance
Type Your Name
First Last
CAPTCHA

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.

Contact Us

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

Tucson, Arizona

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

Follow Us

Follow @ALoyalCompanion
on Social Media

Newsletter Request

Everything you wanted to know about your dog delivered to your mailbox.

© Copyright 2023 – Developed by Affinity For Design.