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02920 001 454

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Refer Online

(For Veterinary Professionals Only)

Now all veterinary professionals can quickly and efficiently refer patients online using our simple form below.

For emergency referrals (Need to be seen within 1-4 hours), please do not use the form below. Please call Valley Veterinary Hospital on 029 2000 1454.

Requirements

Please select the area most suited to your case: *
OrthopaedicSoft TissueMedicineExoticsDentistryCT ScanningPhysiotherapyHydrotherapy

If you have a patient that you would like to transfer to us for out of hours care, please follow the established process for this. If you have any queries please call the hospital on 02920 001 454 to speak with a member of the team. Please Note: All Hydrotherapy patients will have an initial assessment by our Physiotherapist.

Priority *
RoutineUrgent

CT Scanning Disclaimer

By choosing CT Scanning, we will organise for the patient to come to us for a CT scan of the specific area as instructed by you. The CT Report will be interpreted and returned to you to discuss next steps with the client. If you would like to refer the patient for a work up with an appropriate clinician, please select the appropriate clinical area from the options above.

I am happy to proceed

Please select specific body area to scan (select all that apply): *
HeadSpine C1-T2Spine T3-TailThoraxAbdomen (includes Diaphragm to Anus)Carpus to FootElbowShoulderTarsus to FootStiflePelvis/Hip

Do you want to include Contrast? *

For example, are you purely looking for orthopaedic issues e.g. joint dysplasia/fractures or are you concerned about inflammatory/neoplastic process which would warrant contrast.

Please specify any questions to be addressed by the CT Scan: *

e.g. Is there evidence of elbow dysplasia? Is there evidence of metastatic disease in thorax?

Reporting: *
Routine (5 days)Urgent (24 hours)

Client Details

Title *

First Name *

Surname *

Address *

Postcode *

Telephone *

Mobile

Email Address *

Patient Details

Name *

Species *

Breed *

Weight *

Date of Birth *

Colour

Gender and Neutering Status *

Is the patient insured? *
YesNo

Insurance Provider:

Insurance Policy Number:

Is the patient fit for travel? *
YesNo

Has the patient been imported or travelled outside of the UK? *
YesNo

If yes, please specify the countries they have been imported from/visited:

Patient Cautions:

Please provide a summary of the patient’s Clinical History including duration of complaint: *

Onset (per-acute/acute/chronic); any concurrent disease; main findings on clinical examination; any tests already conducted (bloodwork, imaging); response to medication/any current relevant medication; main differential diagnoses.

Documents

Patient History and Supporting Documents: *

Imaging Documents:

Lab Results Documents:

If your documents are located on a third-party system you must first download them to your device and then upload them to this form. Accepted formats: jpg, jpeg, png, gif, pdf, doc, docx, dcm, zip (8MB maximum (4MB for Patient History and Supporting Documents, 2MB for Imaging Documents, 2MB for Lab Results Documents)). To send larger attachments, or if you experience problems uploading your documents via this form, please email (8MB max per email) to referrals@valleyvets.net. Please note: If you try to submit this form and fail to complete the fields correctly, you will need to re-attach the documents before re-submitting the form a second time.

Referring Vet Details

Title *

First Name *

Surname *

Practice Name *

Practice Address *

Practice Postcode *

Telephone *

Email Address *

Other Information

Please tell us why you chose Valley Veterinary Hospital:

Please add additional notes here:

Valley Veterinary Hospital is an RCVS Accredited Practice

Valley Veterinary Hospital has been awarded as a Gold Cat Friendly Clinic

We offer complete package of care Make a Referral

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Valley Veterinary Hospital, Unit 2C, Gwaelod y Garth Industrial Estate, Gwaelod y Garth, Cardiff. CF15 9AA

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