Referrals | Surrey Poultry Vet | Guildford

Dr Henrietta Kodilinye-Sims BVetMed PgDipVEPH GCLT MRCVS

Referral submission form

Please fill in this form if you are a veterinarian wishing to refer a client for advice, or assessment.

You and the client will receive a report via email after the event, including medical or surgical directions if required.

Fees chargeable to the client: £25 per 15 minutes including consultation, visiting time (plus visit charge), tele-consultations, diagnostic investigations, prescriptions, treatments & reporting.

I am to make contact within 24 hours.

Veterinarian details

Name of referring vet

Referring vet - Email Address

Referral type required

Veterinary practice:

Referring vet - Telephone number

Client details

Client - Full name

Permission to contact client directly

Client - Email Address

Client - Telephone number

Case history and patient details:

Tell us how you heard of me:

Thank you. If urgent please contact me on 07930203603.

Referrals

For vets - referrals