Veterinary Consent for Pain Clinic / Acupuncture / Class 4 Laser / Herbal Referral

Owners Details:

Animals Details

Vets Details:

Reason for referral:

Terms & Conditions

• An animal will not be seen without a referral from the primary care vet

• The referral should include a referral form signed by the veterinary surgeon responsible for the patient and a full patient history, including any diagnostic imaging / recent blood results 

• The patient must remain under the care of the referring veterinary surgeon/practice or another primary care practice whilst under the care of Veterinary Acupuncture and Pain Management (for chronic pain management and/or complementary therapies e.g. laser / acupuncture / herbal medicine). 

• The primary care vet should be the first point of call for anything other than that for which referral has been made. 

• Diagnostics / further investigations remain the responsibility of the first opinion vet and any relevant information should be shared with Veterinary Acupuncture and Pain Management so as not to compromise patient care. 

• Patients on long-term medication will be advised to have regular bloods tests and these will be directed back to the first opinion vet practice. The results should be shared with Veterinary Acupuncture and Pain Management at the earliest opportunity as a change in treatment may be required. 

• Any potential side effects of any treatment given / prescribed by Veterinary Acupuncture and Pain Management is discussed in full with the client and they are instructed what to do if these are encountered. 

• Should any animal experience a sudden deterioration in their symptoms, the owners are advise to contact the primary care provider (or their dedicated out of hours service provider) as further investigations / quicker acting “rescue” analgesia / hospitalisation or euthanasia may be required. 

• The primary care vet will be kept updated on any treatments prescribed / given by Veterinary Acupuncture and Pain Management and will be informed of any concerns that requires further investigation / intervention that is outside the remit of Veterinary Acupuncture and Pain Management 

• On referring a patient to Veterinary Acupuncture and Pain Management you are agreeing to the above terms. 

Data Protection 

• Veterinary Acupuncture and Pain Management holds records of veterinary practices and practitioners who have referred clients and their patients to the clinic. This is used use to provide you with updates on the referrals you have made to us or request further information pertaining to our mutual patient. It is also used for insurance claims. 

• All data is stored securely in a locked filing cabinet or on a password protected computer.