Pet Owner Referral Form

As a pet owner you must be referred from a vet practice. If you are not registered with a practice please book an appointment with Horner Vets for a vet assessment to enable a referral.

Start treatment in 3 simple steps:

📋 Fill in our referral form below.
📞 We’ll contact you shortly to book in a time that suits you.
🐶 Come along to the appointment and let’s begin your pet’s wellness journey!

If you have any questions please email us or give us a call on 0121 270 5800.

I confirm I have been referred by a Veterinary Clinic.

Yes

Owner's Details

Name

First Name

Last Name

Phone

(###)

###

####

Pet Details

Pet Name

Pet Date of Birth

Species

Breed

Sex

Male

Female

Colour

Veterinary Surgeon Information

If a vet clinic has referred you to receive treatment with us, please enter their information here. If you do not have a referring clinic please book an appointment with Horner Vets before completing the form.

Name of Referring Veterinary Surgeon

Practice Name

Practice Address

Vet Email

Vet Phone