Refer to Pawra
Referring Vet details
Full name
*
First Name
Last Name
Phone number
*
Practice name
*
Practice postcode
*
Vet e-mail address
example@example.com
Practice e-mail address
*
example@example.com
Patient Details
Patient's name
*
Breed
*
Age (years)
*
Sex
*
Please Select
Male
Male neutered
Female
Female neutered
Fully vaccinated
*
Yes
No
Unknown
Up to date worming
*
Yes
No
Unknown
Reason for referral
Canine Physiotherapy
Multidisciplinary Pain Management
Laser Therapy
Pain Specialist Initial Consultation
Radiofrequency Therapy
Acupuncture
Hydrotherapy
Behaviour Consultation
Fitness Underwater Treadmill (Aquafit)
Weight Management Insights
Canine Conditioning (Canifit)
Canine Massage
Fitness Treadmill (Treadfit)
Brief summary / reasons for referral
*
Approximate date symptoms first started
Radiographs or any images
*
Yes
No
Original recent (last 6 months) lab results and blood work
*
Yes
No
Attach PDF full history along with all additional supporting documents
*
Browse Files
Drag and drop files here
Choose a file
Please e-mail any files greater than 4 MBs to our team at: info@pawra.com
Cancel
of
Owner Details
Title
*
Please Select
Mr
Mrs
Miss
Ms
Other
Full name
*
First Name
Last Name
Phone number
*
-
Country code
Phone Number
E-mail address
*
example@example.com
Address
*
Submit
Should be Empty: