Communication Preference Form

At NorthStar VETS, we are dedicated to saving animals lives, and this year we have made a resolution to save another type of life: trees. Trees clean the air, conserve energy, and even improve water quality. In short, they help save our lives! Electronic communication is environmentally friendly and cost effective, combining the speed and efficiency of the telephone with the written word. For these reasons, we are proud to announce being able to better serve you via electronic communication. We encourage you to join us in this mission; however, we respect your personal choice and will continue to use fax and other methods as specified. Your cooperation will help us to ensure that every veterinarian working at your practice receives their clients' referral letters and any other correspondence from our practice.

Please take the time to compile a list of all the veterinarians, first and last names, in your practice. This form can also be downloaded / printed and faxed back to us promptly to 609-259-8484.

Practice Name:

1. Clinician Name:

When Clients are referred to our practice do you prefer a (Check all that apply):

Email report  - Email Address:

Faxed preliminary report

Telephone call

2. Clinician Name:

When Clients are referred to our practice do you prefer a (Check all that apply):

Email report  - Email Address:

Faxed preliminary report

Telephone call

3. Clinician Name:

When Clients are referred to our practice do you prefer a (Check all that apply):

Email report  - Email Address:

Faxed preliminary report

Telephone call

4. Clinician Name:

When Clients are referred to our practice do you prefer a (Check all that apply):

Email report  - Email Address:

Faxed preliminary report

Telephone call

5. Clinician Name:

When Clients are referred to our practice do you prefer a (Check all that apply):

Email report  - Email Address:

Faxed preliminary report

Telephone call

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