Redstone Animal Hospital and My Pet's Place 

                                      PST  REFERRALS

At RedStone Animal Hospital, we are pleased to be able to accept referrals for Pulsed Signal Therapy.  There are very few PST machines available in Colorado.  We want to make the benefits of this treatment available to as many pets as possible. PST treatments may be a very benficial part of a complete treatment plan put together by your own veterinarian.

We require a written referral from your own veterinarian, with the understanding that the referral is only for the purpose of PST treatment.  You will return to your own veteriunarian for any other treatment.  

                                   REFERRAL FORM

Referral Information
VeterinarianName________________________________________
Clinic or Hospital _________________________________________
Phone Number___________________________________________

Client Information
Owner Name____________________________________________
Pet Name_______________________________________________
Species           Canine____                   Feline____

Medical Information
Diagnosis ______________________________________________
Pre-existing Conditions____________________________________
Radiographs Taken on____________________________________
                                   RedStone Animal Hospital may request that
                                   radiographs accompany pets at the time of
                                   treatment.

Vet/DVM Signature_______________________Date _____              

Pets with cancer should not receive PST treatments. PST may cause increase in the size of any growths.



DVM
Client Name
Pet's Name
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