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+44 (0)1268 564664

24 hour veterinary and nursing care

+44 (0)1268 564664

24 hour veterinary and nursing care

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Online Referral Form

Registration Form for Routine Appointments

NB: This form should ONLY be used by Veterinary Professionals not by clients wishing to make an appointment. If you are a pet owner, either contact your vet for referral or telephone Southfields Veterinary Specialist on 01268 564664 for assistance.

The following form should be completed and accompanied by a referral letter, full clinical history, including laboratory results and radiographs (please supply normal and abnormal results). The history, test results/radiographs and a covering letter can either be uploaded using this registration form (see below) or they can be emailed separately to: [email protected] (if emailing, please include the Referred Case Registration Number which will be emailed to you once this form has been submitted).

To arrange an appointment

After you have submitted the form, our reception staff will contact either you or your client directly to arrange an appointment (depending on your contact preference indicated below).

All information submitted will be held securely and used only by Southfields Veterinary Specialist, and never passed to third parties without your express permission.

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The files listed below are invalid, please resubmit the form using one of the following acceptable file formats
.pdf, .doc, .docx, .xls, .xlsx, .rtf, .txt, .jpg, .bmp, .gif, .tiff, .png, .zip

Please complete the following details:
(NB: This form should ONLY be used by Veterinary Surgeons, not by pet owners)


Please review, correct and resubmit.

Emergency, Urgent and Out-of-Hours Referrals

Please DO NOT use this form for emergency, urgent and out-of-hours referrals, but instead call reception on 01268 564664 to speak to a member of staff.

Referring Veterinary
Surgeon's Details (About You)

* Denotes a required field

In the event of any queries, or if you have indicated below that you wish to book the appointment on behalf of your client, please specify your preferred contact method for arranging this referral:

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Saving your details

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Owner's Details

Please ensure that telephone numbers are current and accurate and include an STD code

In the event of any queries, and for clients preferring to book their appointment with us directly, please indicate the owner's preferred contact method:

Patient's Details


 Years    Months

Has this patient been referred to Southfields previously?

Details of Referral

Processing your registration details

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Clinical History

Clinical history and previously performed diagnostics (please include normal as well as abnormal results)

Please upload a copy of the clinical history including blood tests, urinalysis, cytology or histopathology results and radiographs using the upload button below. A brief referral letter outlining the nature of the referral is much appreciated and can help increase the efficiency of case throughput and follow-up reporting.

For each file please click on the 'Add or Drag Attachments Here' button.

Further information can be emailed to [email protected] remembering to quote the case referral reference number in all correspondence (the referral reference number will be emailed to you automatically once this form is submitted).

Note: We accept files in the following formats: .pdf, .doc, .docx, .xls, .xlsx, .rtf, .txt, .jpg, .bmp, .gif, .tiff, .png, .dcm, .eml, .zip

Attachment Checklist

Attachment review
prior to submiting:

Please review the following attachment/s:

Processing your registration details

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Contact preferences:

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Southfields Veterinary Specialists is a trading name of Linnaeus Veterinary Limited. We will not share this information with other companies for their marketing purposes. For more details on how we use your information please see our Privacy Policy.