School of Veterinary Medicine
Small Animal Hospital Appointment Request Form
Refer a pet
Make a payment
Create Referral
Appointment Type
Red - Life Threatening (Emergency appointment)
Orange - Urgent (Appointment within 72 hours)
Green - Normal (Next available appointment)
Free - Advice
Free - Estimate
Presenting Complaint
For RED cases please complete the EMERGENCY INFORMATION section and phone the Small Animal Hospital (
0141 330 5848
) to arrange immediate referral.
For ORANGE and GREEN cases please provide a short referral letter with recent treatment and test results. A member of clinical staff will contact your practice to arrange an appointment at the hospital - we contact the client not the practice.
In ALL cases please send a copy of the case history, blood tests and radiographs to the hospital to help the patient and reduce the number of tests that need repeating.
Please attach all files in one go, you can select multiple files in the Browse Window by holding down the CTRL key and clicking the files.
You may upload images, PDFs, Microsoft Word documents and Apple Pages documents.
The total file size must not exceed 15 MB.
File Attachments
Referral Letter Attached
History Attached
Blood Results Attached
Radiographs Attached
Clinical Service Required
Behavioural
General Medicine
Neurology
Oncology
Ophthalmology
Orthopaedics
Pain Management
Cardiology
Radiotherapy
Diabetic Clinic
Seizure Clinic
Soft Tissue Surgery
Owner Details
Client Surname
Client Forename
Client Title
Address
Town/City
Post Code
Contact Telephone
Work Telephone
Mobile Telephone
e-Mail Address
Special Needs
Patient Details
Animal Name
Species
Breed
Colour
Sex
Age or Date of Birth
Age
DOB
Insurance Details
Insured (Yes/No)
Insurance Company
Policy Number
Referring Vet Details
Vet Name
Practice Name
Practice Address
Practice Town
Practice Post Code
Practice e-Mail
Practice Telephone
Practice Fax
Emergency Assessment
Collapse
Paresis / Paralysis
Cardiorespiratory Problem
Haematological Problem
Trauma
Seizures
Spinal
Recent Treatments
Recent Anaesthesia
Other Problems
Please note that if a history is not attached we may not be able to assess your referral.
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