Vet to Vet Consultation - Canine Patient - Gold Coast Center for Veterinary Care

PAYMENT IS REQUIRED IN FULL AT THE TIME SERVICES ARE RENDERED. ACCEPTABLE FORMS OF PAYMENT ARE CASH, AMEX, VISA, MASTERCARD, DISCOVER, CARECREDIT, AND SCRATCHPAY. (CHECKS WILL NOT BE ACCEPTED).

Veterinarian Information

Hospital Name(Required)

Doctor Name(Required)

Doctor Email(Required)

Hospital Phone(Required)

Dog Behavior History Questionnaire

Check all abnormal behaviors that apply to your pet. Skip any sections that do not apply.

Which one problematic behavior is your main focus with the doctor to doctor consult?(Required)

Be specific - e.g., Reduce barking on walks at people

Additional information

Additional information regarding aggression at the vet clinic

Medical Diagnoses(Required)

List all current and past health conditions within the past 5 years. If none, write N/A.

Any additional information that the GCCVC Behavior Service needs to know?

Once our Client Service Representatives receive the questionnaire, they will contact the veterinary clinic/veterinarian within 2 business days to the email provided with a link to pay for the consult. After payment of $350 is made and the patient’s veterinary medical records and videos are received via email to behavior@goldcoastcvc.com, the sending veterinarian can expect to receive the behavior report within 3 business days of when the GCCVC Behavior Service is in the office (Tuesdays through Fridays). If you have any questions, please reach out to the Gold Coast Behavior Service at behavior@goldcoastcvc.com.

Vet to Vet Consultation – Canine Patient

Vet to Vet Consultation - Canine Patient

Client Information

Veterinarian Information

Patient Information

Dog Behavior History Questionnaire

Hours: