Therapy Referral Form:

Please read carefully before submitting this referral.

Please could you kindly inform all your client's being referred the following: Dogtown work with the dog's without client's being present, therefore client's cannot stay with their dog's during the first initial consultation or furture sessions. We do spend time discussing the dog's condition, lifestyle, behaviour and their expectations prior to the full assessment. Experience has shown that the dog's respond and relax much more when owners are not present and we get better engagement in the activity and therefore much greater results. Thank you

Example +44 7712345689
Radio options for Sex
Please state all conditions & Injury's on this referral. Thank you
Please state the date, the client first come with the condition or injury.
Please statement any behavioral issues, (Lunges & Growls).

Treatments

Please use this section to indicate treatments & if there is any reason why the pet should not undergo the following treatments.

If you have indicated that this treatment is unsuitable, please explain why here. If the treatment is suitable, please enter "Suitable" here.
Radio options for Pool Hydrotherapy
Radio options for Underwater Treadmill Hydrotherapy
If you have indicated that this treatment is unsuitable, please explain why here. If the treatment is suitable, please enter "Suitable" here.
Radio options for Land Based Physiotherapy
If you have indicated that this treatment is unsuitable, please explain why here. If the treatment is suitable, please enter "Suitable" here.
Radio options for Class 4 Laser
If you have indicated that this treatment is unsuitable, please explain why here. If the treatment is suitable, please enter "Suitable" here.

Other Information

I understand & acknowledge:
Please attached all relevant/required Medical History, (PDF format) Thank you. Please note that there is a maximum of 6mb that you can upload.
Only Veterinarians can sign off the form details Thank you