MedVet Referral

In the case of an emergency, please contact MedVet and notify them you are making an Ellie’s Rainy Day Fund referral. Please follow-up the call with this MedVet Referral Form

Should you have any medical questions or wish to discuss a case prior to referral, please contact the MedVet veterinary specialist in the area you are referring the patient. Please mention you are an ERDF member practice. 
Thank You.

Phone: (937) 293-2714
Email: appts.dayton@medvetforpets.com
This email is checked 7 days a week, multiple times per day.
Fax: (937) 293-2787

    Member Practice

    Patient Information

    Sex:MaleFemale
    Altered:YesNo
     

    Client Information

    Referral Information

    Our goal is to help keep pets and their families together; is this a situation in which the companion animal is considered a part of the family? Will the client’s lack of available funds result in their companion animal not receiving the care necessary to maintain the best health outcome, having to be surrendered or euthanized?

    Medical Reason for Referral

    Date Service Performed

    REMINDER: Please make sure the client receives a copy of our letter and brochure explaining the fund. If you can take a photo of the pet at the time of their visit, please do so and send it to us at info@elliesrainydayfund.org. THANK YOU!