Referral Form



Referral Form

Dear owner, your cat can only be referred to TLCC Ophthalmology by your vet. If you would like a referral please contact your usual practice to arrange this.

Owner's Details
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Owner's Preferred Contact Method
Patient's Details
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Previous Referral
Details of Referral
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Clinical history and previously performed diagnostics (please include normal as well as abnormal results)

Please enclose a copy of the clinical history including blood tests, urinalysis, cytology or histopathology results and radiographs along with this form. 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.

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