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Referral Form

TheSkinVet Dermatology Referral Form

Please complete this online form.  I will then promptly contact the owner to tell them what my service provides, discuss fees and arrange an appointment at their nearest and most suitable clinic.

Well-focused, high resolution photos are often helpful too.

The client must agree to the the transfer of their personal information as per the RCVS general data protection guidelines (March 2018).

Referral Form

"*" indicates required fields

Pruritus?*
Infectious?*
Urgent*

Vets Details

Clients Details

Insurance Details

Insurance cover?*
Ongoing claim?

Animal Details

Sex
Drop files here or
Accepted file types: png, jpeg, jpg, gif, pdf, doc, docx, txt, csv, rtf, Max. file size: 32 MB, Max. files: 10.
    Please upload any relevant clinical history notes, images, and full laboratory reports

    • I have worked in the Brighton area for the last 2.5 years. Starting afresh in a new region can be a bit daunting in part because you have new specialists with whom you can build a rapport and rely on to support you and your clients. I can honestly say that Charlie has helped me immensely during the transfer. He has offered prompt consultations to my clients, with good follow-up and client communication. He has also been available on the phone and by email for advice. And most importantly, he has always been a friendly face at work

      Referring Vet Hannah Capon BA VetMB MRCVS (founder & director of CAM, RCVS Impact Award Winner 2020)

    • … I have found Charlie’s help invaluable…, especially with extremely challenging cases in helping to review & direct further investigation & treatment. I find his approach very supportive of the clinician, rather than taking over completely, which I have been very grateful for.

      Referring Vet: Dr Annette Moyart MA VetMB CertSAM (postgraduate Small Animal Medicine qualification) MRCVS, Downland Veterinary Group, Bognor Regis

    • (I must) compliment you on the details of your referral records! We should all be ashamed that ours are not as nice.

      US Vet Dermatologist: Dr Candace Sousa, DVM, DABVP (Emeritus), Canine & Feline, DACVD (Emeritus)

    • ‘Diego’s skin condition … seems to be improving every day… He is in fine fettle … and his happy loving demeanour is still the same. Thank you for your care & concern for Diego. It is much appreciated. Kind regards.

      Miss Lorraine Trezise, cat ‘Diego’ with rare, severe, herpetic dermatitis (E-Consultation)

    TheSkinVet Dermatology Referral Form

    Please complete this online form.  I will then promptly contact the owner to tell them what my service provides, discuss fees and arrange an appointment at their nearest and most suitable clinic.

    Well-focused, high resolution photos are often helpful too.

    The client must agree to the the transfer of their personal information as per the RCVS general data protection guidelines (March 2018).

    Referral Form

    "*" indicates required fields

    Pruritus?*
    Infectious?*
    Urgent*

    Vets Details

    Clients Details

    Insurance Details

    Insurance cover?*
    Ongoing claim?

    Animal Details

    Sex
    Drop files here or
    Accepted file types: png, jpeg, jpg, gif, pdf, doc, docx, txt, csv, rtf, Max. file size: 32 MB, Max. files: 10.
      Please upload any relevant clinical history notes, images, and full laboratory reports

      • I have worked in the Brighton area for the last 2.5 years. Starting afresh in a new region can be a bit daunting in part because you have new specialists with whom you can build a rapport and rely on to support you and your clients. I can honestly say that Charlie has helped me immensely during the transfer. He has offered prompt consultations to my clients, with good follow-up and client communication. He has also been available on the phone and by email for advice. And most importantly, he has always been a friendly face at work

        Referring Vet Hannah Capon BA VetMB MRCVS (founder & director of CAM, RCVS Impact Award Winner 2020)

      • … I have found Charlie’s help invaluable…, especially with extremely challenging cases in helping to review & direct further investigation & treatment. I find his approach very supportive of the clinician, rather than taking over completely, which I have been very grateful for.

        Referring Vet: Dr Annette Moyart MA VetMB CertSAM (postgraduate Small Animal Medicine qualification) MRCVS, Downland Veterinary Group, Bognor Regis

      • (I must) compliment you on the details of your referral records! We should all be ashamed that ours are not as nice.

        US Vet Dermatologist: Dr Candace Sousa, DVM, DABVP (Emeritus), Canine & Feline, DACVD (Emeritus)

      • ‘Diego’s skin condition … seems to be improving every day… He is in fine fettle … and his happy loving demeanour is still the same. Thank you for your care & concern for Diego. It is much appreciated. Kind regards.

        Miss Lorraine Trezise, cat ‘Diego’ with rare, severe, herpetic dermatitis (E-Consultation)
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