Refer a Pet or Request Advice

Electronic Referral Form

This form should ONLY be used by Veterinary Surgeons, not by pet owners

Emergency, Urgent and Out-of-Hours Referrals

Please DO NOT use this form for emergency, urgent and out-of-hours referrals. Instead, call reception on 01924 908333 to speak to a member of staff

Out of hours is weekdays 6pm – 8am and over the weekend.

Referring Vet Registration Form for Routine Appointments

Click here if you require information about our refer a pet process before completing the Vet Registration Form for routine appointments

If you are experiencing difficulties using our referral form please try using another web browser i.e. Google Chrome

1Vet's details

2Owner's details

3Pet's details

4Referral details

Please complete the following details:

* Denotes a required field
Referring Veterinary

Surgeon's Details (About You)
Your Email Address*
Enter Email Confirm Email

(NB: Each user from a Practice requires a unique email)
Veterinary Surgeon’s name*
Practice name*
Practice Address*
Telephone*

Owner's Details
Owners name*
Address*
Telephone*
Email Address*

Patient's Details
Pet's name*
Species / Breed*
Gender*
Age*

Details of Referral
Discipline to which you are referring:*
Insured for vets fees?
Contact preference for us to make this appointment*
Please describe the condition and the reason for referring*
Clinical History

Clinical history and previously performed diagnostics (please include normal as well as abnormal results)

Please upload a copy of the clinical history including blood tests, urinalysis, cytology or histopathology results and radiographs using the upload button below. A brief referral letter outlining the nature of the referral is much appreciated and can help increase the efficiency of case throughput and follow-up reporting.
Further information can be emailed to referrals@paragonreferrals.co.uk remembering to quote the case referral reference number in all correspondence (the referral reference number will be emailed to you automatically once this form is submitted).
File
Drop files here or

Accepted file types: pdf, doc, docx, xls, xlsx, rtf, txt, jpg, bmp, gif, tiff, png, dcm, eml, Max. file size: 64 MB.
Note: We accept files in the following formats: .pdf, .doc, .docx, .xls, .xlsx, .rtf, .txt, .jpg, .bmp, .gif, .tiff, .png, .dcm, .eml
Contact preferences:

We would like to send you our newsletters, contact you about promotions and CPD events which may be relevant to you by post, email and SMS. Please tick here if you would not like to receive information about our CPD or other marketing information:
Paragon CPD
- Yes
- No
Marketing Permissions

Paragon Veterinary Referrals will use the information you provide on this form to be in touch with you and to provide updates and marketing. Please let us know all the ways you would like to hear from us:
Email
- Yes
- No
Post
- Yes
- No
SMS
- Yes
- No
CAPTCHA

Once submitted, you will receive an email confirming your submission and providing you with a Referred Case Registration Number. In the event that you do not receive this, you may need to whitelist our email address (no-reply@paragonreferrals.co.uk, referrals@paragonreferrals.co.uk).

Refer a Pet or Request Advice

Electronic Referral Form

This form should ONLY be used by Veterinary Surgeons, not by pet owners

Referring Vet Registration Form for Routine Appointments

Referring Veterinary

Surgeon's Details (About You)

Owner's Details

Patient's Details

Details of Referral

Clinical History

Contact preferences:

Marketing Permissions

Refer a Pet or Request Advice

Bringing Your Pet to Paragon

More About Paragon

Where to find us