Referrals

Referral Process

Our referral process is straightforward. Once your veterinarian refers your pet to us, you can contact our hospital directly to schedule an appointment. We encourage you to bring all relevant medical records to help us provide the best possible care.

Date(Required)

Owner (First name / Surname)(Required)

Address(Required)

Owner's phone number(Required)

Referring Veterinary Surgeon's Name(Required)

Referring Veterinary Clinic Contact Details (please include fax no)(Required)

Referring Vet Email(Required)

Pet Details:

Name(Required)

Breed(Required)

Age(Required)

Sex(Required)

Has the patient been to us before?(Required)

Please list the patient's other medical conditions(Required)

Please list all medications the patient is receiving at the time of referral (please include non eye related medications)(Required)

Details of the problem:

Affects the(Required)

Duration / Date of onset*(Required)

Visual Deficit?(Required)

Pain?(Required)

Change in appearance?(Required)

Please summarise your concerns / comments / relevant history / response to treatment and advise us of the urgency of the referral(Required)

Please note we do not phone clients to make an appointment so please ask the owner to contact us to arrange the referral time, and please send us PDFs of the relevant history and results of any blood work / tests to reception@pertheyevet.com.au or upload them here.

File

Max. file size: 128 MB.

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Referral Process

Pet Details:

Details of the problem:

Perth Animal Eye Hospital

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