Veterinary Referral Form

This section is for veterinary professionals only. If you are an owner, please visit the ‘Owner Forms’ section above to complete the appropriate form.

Under the Veterinary Surgeons Act 1966 and the Veterinary Surgery (Exemptions) Order 2015, animals receiving physiotherapy for an injury, medical condition, or rehabilitation require veterinary consent prior to treatment. We kindly ask that a veterinary referral form is completed for all treatment cases, with the exception of routine maintenance appointments.

Please find our veterinary referral form attached below. Alternatively, you may complete the online referral form located at the bottom of this page.

Referral Form

Why Choose AMORE?

✔ IMSc Qualified Veterinary Physiotherapist
✔ RAMP Registered Practitioner
✔ Fully Insured & Evidence-Based Practice
✔ Level 4 Advanced UWTM Qualified
✔ Detailed Clinical Reporting & Vet Communication

Working collaboratively with veterinary surgeons, we provide tailored rehabilitation and maintenance physiotherapy with patient welfare and long-term outcomes at the heart of every treatment plan.

Veterinary Referral Form

Please ensure all required sections are completed prior to submission.

Owner First name

Owner Last name

Phone

Address (Optional)

Is the animal insured?

Yes

Brief history/ reason for referral

Veterinary Practice & Referring Surgeon

Would you like to discuss the case prior to treatment?

Yes

I confirm physiotherapy is appropriate for the above animal in relation to the stated condition/episode of care and may be carried out by an appropriately qualified and insured Veterinary Physiotherapist at their discretion. Signed:

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To support the best possible treatment outcomes, we would greatly appreciate any relevant veterinary history for the above animal, where appropriate, to assist with assessment and ongoing case management.