Small Animal Internal Medicine Consultation Form

This form is to submit information to the small animal internal medicine service ONLY for consultation purposes. If you are a veterinarian needing to refer a patient to the Bailey Small Animal Teaching Hospital, you will need to complete a referral request here. If this is an emergency, call (334) 844-4690. Consults will be answered in approximately 2 business days Monday-Friday.

Veterinarian Info

Veterinarian Name(Required)

Patient Info

Owner's Name(Required)
Species(Required)
Sex(Required)

Consultation Info

What are the main questions and/or concerns that you would like us to address?
Drop files here or
Accepted file types: jpg, gif, png, pdf, Max. file size: 24 MB, Max. files: 6.
    Drop files here or
    Accepted file types: jpg, gif, png, pdf), Max. file size: 24 MB, Max. files: 6.
      Include treatments and treatment details (dosage, route, duration) and any clinical response.