Veterinary Dermatology Referral

APPOINTMENT

Refer a Patient

Please fill out the form below to refer a patient to Coastal Virginia Veterinary Dermatology.

Referring Veterinarian *

Email *

Clinic Name *

Clinic Phone *

Clinic Fax *

Client Name *

Client Address

Address Line 1

Address Line 2

City

State

Zip Code

Client Phone *

Pet Name *

Age *

Sex *

Species *

Breed *

Reason for Referral *

Dermatologic History

Other Pertinent History

Current Medications

Date of Last Rabies Vaccination

Please attach records/doctor notes and lab results for the last 1-2 years

Click or drag a file to this area to upload.

Name

Contact Info

Virginia Beach
Phone: (757) 866-2320
Fax: (757) 866-2326
Email: [email protected]

Yorktown
Phone: (757) 596-7100 Ext. 2

Location

3296 Dam Neck Rd
Virginia Beach, VA 23453
Click here for directions.

Peninsula Animal Referral Center (PARC)
1120 George Washington Memorial Hwy, Yorktown, VA 23693
Click here for directions.

Virginia Beach Hours:

Monday: Closed
Tuesday-Friday: 8:00 am-4:00 pm
Saturday: By Appointment
Sunday: Closed

Yorktown Hours:

Monday: Closed
Tuesday: 12:00 pm-7:00 pm
Wednesday: By Appointment Only
Thursday: Closed
Friday: 9:00 am-5:00 pm
Saturday: By Appointment
Sunday: Closed