Toggle navigation
About Us
Meet the Team
Careers
Our History
Location
Information
Refer a Client
Giving Feedback
RCVS Practice Standards Scheme
Terms & Conditions
Services
Diagnostic Imaging
Cardiology
Internal Medicine & Oncology
Soft Tissue Surgery
Exotics
Dermatology
Orthopaedics
Contact Us
Call Us:
01744 853510
Refer a Client
Emergency
Refer a Client
Home
>
Information
>
Refer a Client
If you need to refer a client urgently, please fill this form AND contact us on 01744 853 510.
If you are human, leave this field blank.
Referring Veterinary Surgeon's Details:
Name
*
Practice
*
Practice Address
*
Practice Postcode
*
Telephone Number
*
Fax Number:
Email
*
Client Details:
Client's Name
*
Patient's Name
*
Client's Address
*
Town
*
Postcode
*
Telephone
*
Client's E-mail Address
*
Patient Details
Name
*
Species
*
Age
*
Colour
*
Sex
*
D.O.B
*
Breed
*
Neutered?
*
Which department do you require?
Department
*
Dermatology
Orthopaedics
Internal Medicine
Soft Tissue Surgery
Out-patient CT/MRI (only)
Cardiology
Oncology
Exotics
Neurology
What is the specific problem/investigation/treatment for which you wish to refer the patient ?
*
History / X-rays will be sent via
*
E-mail: referrals@rutlandhousevets.co.uk
History / X-rays File Upload
*
History / X-rays File Upload
History / X-rays File Upload
History / X-rays File Upload
History / X-rays File Upload
History / X-rays File Upload
History / X-rays File Upload
History / X-rays File Upload
History / X-rays File Upload
History / X-rays File Upload
Please contact me prior to the appointment to discuss the case.
*
Do you want a receptionist at Rutland House Refferals to contact the client and make an appointment ?
*
Yes
No
For further information, please call: 01744 853510
Keeping in touch
by email
by phone (including text message)
by post
Yes please, I would like to receive reminders (i.e. appointments, boosters and treatment reminders)
by email
by phone (including text message)
by post
Yes please, I would like to receive marketing communications (i.e. products and services)
Terms & Privacy
*
I agree and I am over the age of 18
I agree to have read and accepted your
terms
and
privacy policy
. Your privacy is important to us and you can find out more about how we use your data from our “Full Privacy Notice” which is available from in the links above.
Captcha
*
reCAPTCHA is required.
Submit