Ensure your referral goes smoothly

If you think your case is an emergency, please contact the surgery BEFORE sending this form.

Animals need to be referred to us via the first opinion vet. We regret that we cannot accept referral forms from pet owners directly.

Referring veterinary surgeons, please fill in the form below or download a PDF version of the referral form by clicking here.

ALL sections of the referral form MUST be completed. Incomplete referrals will not be processed.
Comments such as ‘see history’ will not be accepted and returned to you for completion.

Please attach a full history including blood results
or email them to admin@eye-vet.co.uk

Client Information

Animal Information

Practice Information

Conditions


Emergency - You MUST call the practice before sending this online referral form as this is deemed an emergency.
Low Priority - Will be seen within 1-2 weeks
Emergency1-3 daysWithin 1 weekLow Priority

CataractsGlaucomaCorneal UlcerUvetisTraumaSudden BlindnessLens LuxationEntropion/EctropionKCS (Dry Eye)DistichiasisKeratitisOther

Medical Details

Comments such as 'see history' will not be accepted and returned to you for completion

By submitting this referral request I:

(1) confirm that I have the consent of the above named client to pass the above information to you for the purposes of case referral; and
(2) agree to be bound by the Eye-Vet/Pets at Home Vet Group Privacy Policy, which explains how the data I have submitted will be used