Referral Form for Vets

Please complete the online form below and click ‘Submit’. The Submit button will not be enabled until all required fields (marked with *) have been completed. You will be directed to a new page when your referral has been sent. 

If you have any issues submitted the form below, please email a cover letter & history to reception@elhamvalley.com and we will respond.

In an emergency or out of office hours please call us first on 01303 840499

Referring Vet's Name
Select the first "not in list" option if required.
Client's Name
Species
Please indicate
Please indicate
Is the patient insured for veterinary fees?
Case urgency
Please include any details of importation from Brucella canis endemic regions and any Brucella lab results
Drag & Drop Files, Choose Files to Upload You can upload up to 6 files.
Please upload any relevant notes etc

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