Vet Referral Form (Vets use only):

If you are a veterinary practice and you would like to refer a dog for hydrotherapy & physiotherapy, please complete the form below.

If you have any queries, please call 0208 995 2060.

Experience has shown that the dog's respond and relax much more when owners are not present

Dogtown Rehab Team treat the dog's without owners being present. Before the full assessment, we take time to discuss the dog’s condition, lifestyle, and behaviour and understand owner expectations.

Example Smith, John Please enter all present names.
Example +44 7712345689
Please enter the surname if it different to clients details above
If mixed breed, Please state all breeds if known.
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).

Practice Details:

Treatments:

Please use this section to indicate treatments & if there is any contraindications. Condition or Situation why treatment should not be used.

Radio options for Pool Hydrotherapy
Radio options for Underwater Treadmill Hydrotherapy
Radio options for Land Based Physiotherapy
Radio options for Class 4 Laser
Important, if there is any contraindications, to the below Treatments ( Please state them here):

Other Information

I understand & acknowledge: