Important Message to Our rDVMs and Clients

As we prepare for possible “Shelter in Place” in the state of NC, we wanted to establish a clear line of communication with our referring veterinarians to be as prepared as possible for your patient’s potential medical needs.

We plan to be here – fully staffed – to care for the urgent and critical needs of your patients during this COVID-19 Pandemic.

We ask that you instruct your clients to go to our website to familiarize themselves with our new intake policy before “Shelter in Place” goes into effect.

Please communicate with your clients as to what to expect from your hospital and send them instructions. Consider refilling medications for the next 30 days and direct clients to the use of online pharmacies.

Because we have to practice the best veterinary medicine for your patients we ask that you please alert your clients with direction – establish a form of communication from you to your client and vice versa, submit prescription refills to online pharmacies or let them know that they will need to get a full physical examination and possibly perform any lab tests in order to refill any medications that has been previously been prescribed by you, as their family veterinarian.

As stated by the NC Veterinary Medical Board as an important update (below), medications cannot be prescribed by a Veterinarian without a client/patient relationship. We want to make sure that your clients understand that, by law, our hospital cannot just refill prescriptions without this.

COVID-19 and the Veterinary-Client-Patient-Relationship

For a veterinarian to practice medicine in the State of North Carolina they need to first establish a veterinary-client-patient-relationship (VCPR).

A VCPR is established only when a veterinarian examines an animal in person, and is maintained by regular veterinary visits as needed to monitor an animal’s health. If a VCPR is established but a veterinarian does not regularly see the animal afterward, the VCPR is no longer valid and it would be illegal and unethical for a veterinarian to dispense or prescribe medications or recommend treatment without recently examining the patient.

A valid VCPR cannot be established online (virtually), via email, or over the phone. However, once a VCPR is established, it may be able to be maintained between medically necessary examinations via telephone or other methods; but it’s up to the veterinarian’s discretion to determine if this is appropriate and in the best interests of an animal’s health.

A VCPR is present when all of the following requirements are met:

  • The veterinarian has assumed responsibility for making clinical judgments regarding the health of the patient, and the client has agreed to follow the veterinarian’s instructions.
  • The veterinarian has sufficient knowledge of the patient to initiate at least a general or preliminary diagnosis of the patient’s medical condition. This means the veterinarian is personally acquainted with the keeping and care of the patient by virtue of a timely and medically appropriate examination of the patient.
  • The veterinarian is readily available for follow-up evaluation or has arranged for the following: veterinary emergency coverage, and continuing care and treatment.
  • The veterinarian provides oversight of treatment, compliance and outcome.
  • Patient records are maintained.

What is a “timely and medically appropriate examination of the patient by the veterinarian”

This time frame can vary greatly due to the age of the animal and existing health conditions. This decision can be made by the VCPR-DVM with the best interests of the client and patient in mind.

The following are examples:

  • A young healthy animal may only need to be seen once a year to establish a VCPR. However, an older animal will require more frequent examinations to ensure their health status.
  • An animal with existing health problems such as epilepsy, heart disease, renal disease, etc. will require more frequent examinations to maintain a valid VCPR.

Within an established VCPR

A veterinarian may remotely gather essential veterinary medical information from the animal owner or other caretaker; access the patient’s medical records; and utilize patient information from a variety of sources (photos, videos, etc.).

Without an established VCPR

The veterinarian may provide general advice but must specifically stay clear of diagnosing, prognosing, or treating patients. Advice should not be specific to an individual animal, diagnosis or treatment. In addition to being helpful, use the time to acquaint the caller with the value of your practice and services and try to schedule an appointment for the caller if the case is urgent, or if not, for a time after the crisis has eased.

Thank you for entrusting your patient’s medical care with us.
Stay Safe and Healthy!


Scott R. Helms, DVM, DABVP
Medical Director
Veterinary Referral Hospital of Hickory