Referral Form

Please note: This form should be completed by a referring veterinary professional.

Please use this form for routine referrals only, for urgent and emergency cases please call us on 01962 767920 and choose option 1; our priority line and we will deal with your case immediately.

To refer a routine case to us please complete the form below and press ‘submit referral’, you will receive confirmation that your case has been accepted.

Our client care team will contact your client directly to arrange a convenient appointment time for them for an initial consultation to talk about next steps.

If you do not receive a confirmation e-mail within a few minutes, please check your junk or spam folders and mark the message as not spam to avoid problems receiving our emails in the future.

"*" indicates required fields

Referring veterinary surgeon

Practice Address*

Client details

Name*
Address*

Patient details

DD slash MM slash YYYY

Case details

Service to be referred to*
How soon does this case need to be seen?*
For same day emergencies and urgent referrals that need to be seen the next day, please call us directly on 01962 767920 rather than completing this form.
Diagnostics Performed
Please indicate which (if any) tests that are available and click 'Choose File' below to attached any supporting documents to your request.
Please attach all history, lab test results and xrays for your case.
Drop files here or
Max. file size: 20 MB.
    (Estimates for common conditions are available here or otherwise please call us on 01962 767920)
    Consent*
    You, as the treating Veterinary Surgeon, confirm that you have all necessary rights and legal bases, and/or have obtained consent, to collect and share the personal data of the Owner with Anderson Moores and the Linnaeus family of veterinary businesses for the purpose of veterinary treatment. You agree to indemnify Anderson Moores and the Linnaeus family of veterinary businesses in the event that you do not have the lawful rights to collect, use and share the personal data of the Owner.