Referral form

Please complete our online referral form and we will be in contact with you soon.

For emergency referrals, please contact the practice directly on 0131 332 0458.

*denotes mandatory field.

Referring vet details
Referring vet*
Practice name*
Contact telephone*
Email*

Owners details
Title
Owner's first name*
Owner's surname*
First address line*
Second address line
Town*
County*
Postcode*
Owner's email
Owner's contact telephone*
Patient details
Name*
Breed*
Species*
Gender*
Neutered?*
Age*
Weight (Kg)

Outline problem*
Current medication*
Urgency of referral*:*
Documentation
Drop files here or

Accepted file types: jpg, gif, png, pdf, docx, doc.
Data Protection: We will use the personal information you give us exclusively for the purposes of referrals. We will not pass on any of your details to any outside organisations or individuals unless with your express consent.