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General Referral Form

This form is only for use by veterinary surgeons to arrange full consultation/referral. Referral forms for outpatient CT can be found here.

If you have a pet who you wish to be seen at South Devon Referrals, please contact your veterinary practice and ask them to contact us to arrange referral. We will then contact you to arrange a convenient appointment time.

You will receive a copy of the online referral by email: if you do not receive this then please contact us by other means to confirm we have received your referral (please check your spam folder).

All items marked with an asterisk (*) are required. Please check they are completed and once you have submitted the form ensure you receive the message “Your message was sent successfully, and we have sent you a copy. Thank you.” which will appear under the submit button.

Referral Details

What type of case is it?:

Practice Details

Client Details

Patient Information

History

Has this animal been imported or travelled abroad?:
If yes, has this animal had a negative Brucella antibody test at least 3 months after return to the UK?:
Please note, we will not accept referrals for travelled animals without evidence of a negative Brucella test. Positive animals will unfortunately not be accepted for referral.

Upload relevant history or other files

Please attach the appropriate case history and any additional records e.g. test results, radiographs, ECG tracings etc (Max total file size 8MB).

Insurance

Is the animal insured?:

It is the responsibility of the referring practice to send up to date history and relevant lab work prior to the patient being seen.

 

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