Refer A Case 

If you would like to refer a case to us please fill out the below form, ensuring the following documents are attached:

 • Full history from current and previous practices

 • Lab results

 • All diagnostic images, where applicable.

Please note that without these documents we will be unable to process this referral.

We aim to respond within three working days. For emergency referrals please fill out the form and call us on 02922 362166.

Alternatively, we can offer history and imaging review service, for £60.
To organise a case review, please fill out the below form and in 'additional notes' please include the name and address you would like us to send an invoice to. Once we have received payment we aim to provide a full review within 10 working days.

Practice name

Referring vet name

Referring vet email

Referring vet contact number

Client title

Client first name

Client surname

Client full address

Client contact number

Additional contact number

Client email address

Patient Name

Patient species

Patient breed

Patient date of birth

Patient sex

Insurance details

Is this a referral or case review?

Referral

Case review

Reason for referral

Full clinical history

Upload file  

Diagnostic images

Upload file  

Laboratory results

Upload file  

Additional comments (E.g. PBFD positive, MRSA positive)

Where did you hear about Origin Vets Clinic?

Thank you for referring a case to Origin Vets Clinic.

We aim to respond within three working days. However, during busy periods, this may be longer.

If this is an urgent referral, please contact us directly on 02922 362 166.

Kind regards,

Origin Vets Clinic

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