White Glove Service

Name: Harrisburg Regional Veterinary Surgical Specialty
Address: 989 East Park Drive, Suite A, Harrisburg, PA, 17111, United States
Telephone: 717-599-6131
Price range: $

To schedule an appointment ONLY: 717-599-6131
To check in ONLY: 717-599-4259

For everyone’s safety, we are currently operating 100% curbside. Our White Glove service provides the same excellent care to your pets. We are not allowing clients inside our building at this time. When you arrive at our practice, please call us at 717-599-4259 and our team will provide instructions for the next steps.

Referral Form

GET STARTED

Thank you for thinking of us!

This form should ONLY be filled in by a veterinary team member (i.e. not by a pet owner).
Then we’ll be in touch with you and your client ASAP.

Clinic Name *

Clinic Phone Number *

Referring DVM *

Clinic Email Address *

Client Name *

First

Last

Best Number to Reach Client *

Client Email Address

What service do you need? *

An estimate
A second opinion on a case
A second opinion on X-rays that I will send in JPEG format
To schedule a surgery
Other

If other, please explain *

Patient Name *

Species *

Canine
Feline
Other

If other, please specify *

Breed *

Age in Years/Months (not DOB) *

Weight (IN POUNDS) *

Gender *

Intact Male
Neutered Male
Intact Female
Spayed Female

Is the patient up-to-date on vaccines? *

Yes
No
Unknown

Is rabies up to date / when does it expire? *

(ex: Yes / 12-12-2024)

Any heart murmur? *

Any health concerns we should know about before anesthesia or surgery? *

If yes, please explain *

Summary of doctor's exam *

Please briefly explain patient's medical history *

Relevant medications (e.g. NSAIDs, steroids) *

Tentative Diagnosis *

Relevant lab work (FNA, biopsy) or radiology/ultrasound report available? *

If yes, please email to [email protected]

Have X-rays been taken? *

If yes, please email x-rays as JPEGs to [email protected]

Diagnostics Performed (please email results to [email protected] or upload below)

CBC
Chemistry
Radiographs
Ultrasound
Urinalysis
MRI
CT scan
Other

Please explain. *

X-RAYS MUST BE IN JPEG FORMAT.

Email Medical Record & Diagnostics to [email protected] or upload here:

Click or drag files to this area to upload. You can upload up to 10 files.

Please upload in JPEG format (no zip files).

Signature *

Date *

Comment

We help your pet get back to feeling their best.

Harrisburg Regional Veterinary Surgical Specialty is the first and only local veterinary surgery center in the Harrisburg area. We partner with your family vet to provide your pet with surgical expertise in orthopedic, “soft tissue” and cancer surgery. All we do is surgery!

We proudly serve pets from Harrisburg, Mechanicsburg, Carlisle, Gettysburg, York, Lancaster, and Reading.

We have even treated cats and dogs from far away in Pennsylvania (Allentown, State College, Philadelphia, Pittsburgh, Stroudsburg, Scranton), New Jersey (Morris Plains, Sparta), Maryland (Baltimore), New York (Manhattan, Buffalo) and more!

Need a hotel? We have so many clients from out of town and out of state that we created a list of nearby pet-friendly hotels.
Simply ask for it, so you don't have to reinvent the wheel.

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Location

989 East Park Drive, Suite A
Harrisburg, PA 17111

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Contact Info

P: 717-599-6131
E: [email protected]

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Hours

By appointment only.

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We will be in touch with you!

Name *

First

Last

Email *

Phone

How may we help you? *

Please Upload Medical Records (PDF), Blood Work (PDF), or X-Rays (MUST BE IN JPEG FORMAT) Here

Click or drag files to this area to upload. You can upload up to 10 files.

Message

Have questions?

Click the button below or call us directly at 717-599-6131. We'll be here to answer any and all of your questions.

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