Advice Request Form

This form is for completion by Veterinary Surgeons only, seeking non urgent advice from our referral clinicians. Please phone us on 028 90471361 if you have an urgent query.

Advice Form

Please note: This form must be completed by Veterinary Surgeons only.

What type of advice do you require?*:

Orthopaedics (including neurosurgery)
Internal medicine (including medical oncology and medical neurology)
Soft Tissue Surgery (including surgical oncology)
Ophthalmology

Practice Details

Veterinary Surgeon*:

Practice*:

City*:

Postcode*:

Phone Number*:

Email*:

Patient Details

Pet Name*:

Species:

Sex:

Neutered:

Yes
No

Breed:

Age:

What question would you like answered?*:

(max 1500 characters)

Please attach all history, lab test results and xrays for your case:

Attach a File:

Security Question:

Select a surgery:

I have read and agreed to the privacy notice: