Referring a Patient for In-Person Assessment

To refer a patient to us for an in-person consultation simply fill in the form below. We will triage the case and contact the client directly to arrange an appointment.

For in-person referrals to Dr Petra Price please contact Totally Vets Feilding on 06 323 6161

We also now offer Remote Consultations. For more information please click here

Urgency

This is an urgent referral

For all urgent referrals please email photographs of the eyes to reception@peteyecare.co.nz for triage

Remote consultation is usually the fastest way for us to provide urgent case management advice, so consider submitting urgent referrals for remote consults instead. See www.peteyecare.co.nz/remoteconsults for more information and the submission form

Which clinic would you like to refer to? *

Hamilton (Small animal referrals, consultation fee $260)
Cambridge (Equine referrals, consultation fee $515, please also email photos for triage to reception@peteyecare.co.nz)

Animal's name *

Client's name *

Client's best contact phone number *

Client's email address

Referring veterinarian *

Referring clinic *

Best email address for the referring clinic *

For referral letters and other relevant communications about the case

Brief summary of the eye problem *

Does the patient have…

Diabetes
Addisons
Neck/spinal/neurological disease
Cardiac disease
Renal disease
Liver disease
Immunological disease
Anything else that may impact our care of the patient?

If so please give a brief summary of the relevant history below:

Is the patient on any medication for the eyes *

If yes please list below:

Is the patient on any other medications? *

If yes please list below:

Do you have any additional questions/comments about this case prior to referral?

Please upload the patient's clinical notes here:

Drag & Drop Files, Choose Files to Upload

Maximum size for uploads here is 2MB. If your file is larger than this, or you have any issues, please submit the rest of this form and then email the notes to reception@peteyecare.co.nz (max 20MB/email)

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