Appointments and Referrals

For Owners…

To book an initial appointment, please fill in the ‘New Client’ online form below. Alternatively, download our veterinary consent form, get it filled out by your registered vet, and return via email.

For Vets…

To make a referral, please download and complete our veterinary referral form below and return via email to chloehoskinsvetphysio@gmail.com.

Forms

Veterinary Consent Form (for Owners)

Veterinary Referral Form (for Vets)

Why Veterinary Consent?

In accordance with The Veterinary Surgeons Act (1966), Veterinary Physiotherapists are legally required to work under veterinary referral and must obtain consent prior to treatment. However, this excludes healthy animals that only require maintenance physiotherapy.

For animals with previous and current diagnosed conditions, and those under ongoing veterinary care, I will need to contact your vets to obtain consent to treat and request their up to date history.

In the event where an unknown lameness, injury or underlying condition is identified during a physiotherapy session, animals will be referred back to their vet and treatment will be stopped until a clinical assessment has been performed and further physiotherapy is recommended.

New Client Form

Please complete the form with as much information as possible to book an initial appointment.

This information will allow me to contact your veterinary practice and either gain consent to treat for those with ongoing medical conditions or simply notify them of treatment for maintenance cases.

Please read through our terms and conditions before accepting the consent statements at the end of this form.

Terms and Conditions

Your Name

First Name

Last Name

Email

Phone

(###)

###

####

Home Address

As this is a mobile service, please provide any additional directions if your house/yard is tricky to find, in addition to any parking details if there is not space directly outside your house. Thank you!

Yard Address (if applicable for equine clients)

Animal's Information

Name, Age, Species, Breed, Sex

Registered Veterinary Practice

Is your animal currently undergoing veterinary care for an illness or injury and/or does your animal have any diagnosed medical conditions?

Yes

No

If yes, please provide details (E.g. medical conditions / treatment provided / current medications)

Do you currently have any concerns with your animal's health or behaviour? (E.g. performance issues, abnormal behaviours, abnormal movement, potential areas of discomfort?)

Which days and times of the week tend to work best for you for an appointment?

Limited weekend and evening appointments are available.

I do / do not consent to the use of photographs / videos containing the above-named animal on promotional material / platforms.

I DO consent

I DO NOT consent

Owner Consent Statements:

1. I consent to the above-named animal receiving veterinary physiotherapy assessment and treatment by Chloe Hoskins Veterinary Physiotherapy. 2. I confirm that the information given above is true and accurate to the best of my knowledge. 3. I have read through and accept the terms and conditions outlined by Chloe Hoskins Veterinary Physiotherapy. 4. I accept that where an unknown injury or underlying condition is identified, treatment will stop until my vet has undertaken a clinical assessment and delegated the need for physiotherapy.

I accept the consent statements

I would like to discuss these further before consenting