Behaviour problems may arise both directly and indirectly as a result of concurrent or previous medical problems.

Veterinary involvement is therefore essential in eliminating organic causes of the problem and prioritising the diagnostic and treatment strategy to be used in any given case.

In order to safeguard the welfare of your patient and indicate your approval of referral, please complete the following form.

Vet Referral Form

Referral form for animal behaviour cases:

Please note that until a case is released to another veterinary surgeon then you, as the client’s normal veterinary surgeon, remain responsible for the treatment, advice and any prescription given.

A copy of the client behaviour report and pertinent notes will be send post consultation for your patient records.

*Vet use only

Referring / Contact veterinary surgeon

MRCVS

Practice name

Client full name

Clients email

(if you are referring direct to us)

Clients phone number

(if you are referring direct to us)

Patient name

Brief description of problem behaviour

Date first noticed/reported to vet

(if mentioned)

Any further comments

Has euthanasia been considered?

(to your knowledge)

Yes

Has psychopharmacology been considered?

(to your knowledge)

Yes

Date of last health check

Is the patient on any medication?

I hereby acknowledge my approval for the client described to be referred for management of the current behaviour problem to Minds Alike Animal Behaviour.

I have emailed a patient history (noting this referral) to info@mindsalikeanimaltraining.com

I agree

Please note - In order to ensure there is no fraudulent activity in relation to this referral (i.e. a non-vet completing the form), if the patient history is not emailed I cannot accept this form alone as a completed referral.

Part of the above associations