Refer a case

• Which Vets Now Hospital would you like to refer to? Manchester
• Which Speciality would you like to refer? Emergency & Critical CareInternal MedicineNutritionOrthopaedic SurgeryOutpatient CTOutpatient MRISoft Tissue Surgery

Your Details

• Referring Veterinary Surgeon
• Referring Practice
• Email
• Phone
• Mobile
• If we need to contact you regarding your referral, how do you prefer to be contacted? Phone/MobileEmailNo Preference

Your Client

• First Name
• Last Name
• Address
• Email
• Phone

The Pet

• Pet Name
• Pet Age
• Species Include the breed
• Sex Include if the pet has been neutered
• Any current medication? Include the duration of the medication
• Condition for referral

The Referral

• Is the appointment… an emergencyurgent/next-daynot urgent/next available appointment
• Have we given you an estimate for this referral? yesno
• Have you given the client an estimate for this referral? yesno
• Are you happy for us to call your client to arrange the appointment? yesno
• Any relevant information?
• [recaptcha]