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A dog at a lake between mountains. Traveling with the pet. Australian Shepherd. Nature. Au

Veterinary Referral Form

As per the APBC code of conduct, I see all behaviour cases on Veterinary referral. Therefore, I ask for the referral form below to be completed for behaviour referrals, and for a copy of the patient's clinical history (including any test results) to be uploaded.

If you prefer, a copy of the form can be downloaded here and emailed to, along with the clinical history.

After consultations, I provide referring Veterinary Surgeons with a summary report to keep you and your client's records up to date.

Practice Details

Client Details

Patient Details

If referring directly, how would the owner prefer to be contacted?


Clinical history

Please upload the patient's clinical history, including any test results.

Upload History
Upload Additional File
Upload Additional File
Upload Additional File
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