Vet Professionals Refer a Case How to Refer Emergency Cases Request Advice CPD Residency Programme Internships Fixed Prices Orthopaedics Neurology Veterinary surgeons only Refer a Case Emergency Cases We see all TPLO cases within 48 hours* New Fixed Price - £4,350 Learn More Refer a Case Please complete the online referral form below. For emergency cases, please phone us on 01928 711400 1Vet Practice Details2Pet Owner Details3Patient Details4Investigations to Date Service required(Required)Please select a serviceDiabetic ClinicInternal MedicineNeurology/NeurosurgeryOncologyOrthopaedic SurgeryPain Management ClinicPhysiotherapySoft Tissue SurgeryDiabetic Clinic Patients(Required) Tier 1 - for diabetes management but also for other comorbidities. Tier 2 - for diabetes management (diet, insulin type and dose, exercise regime, etc.). Tier 3 - this service is suitable for non-urgent queries. Please use Request AdviceVet Practice DetailsReferring Vet Name(Required)Address(Required) Address City Postcode Telephone Number(Required)Mobile NumberEmail(Required) Preferred contact for reports(Required) Email Post Name(Required)Address(Required) Street Address City Postcode Telephone Number(Required)Mobile numberEmail(Required) Insured?(Required) Yes No Insured with which company?(Required) Name(Required)Age/DOB(Required)Sex(Required) Male Female Male Neutered Female Neutered Breed(Required)Species(Required)Brief summary of presenting complaint/reason for referral(Required) X-rays(Required) Yes No Emailed ECG(Required) Yes No Emailed Urine analysis(Required) Yes No Emailed CT/MRI(Required) Yes No Emailed Ultrasound(Required) Yes No Emailed Other laboratory resultsFull clinical history will be:(Required)Attached to formEmailed (to [email protected])Do we have permission to speak to the lab on behalf of the owner?(Required) Yes No Attachments(Required) Drop files here or Select files Max. file size: 100 MB. Upload full clinical historyCurrent medical treatments/medicationsHas the dog travelled abroad in the past 5 years, and if so, where?Consent I agreeBy submitting this form to Northwest Veterinary Specialists (“NWVS”), I/we confirm that I/we have express consent from the individual(s) concerned to transfer the personal data set out in this form to NWVS.