HT Animal Rehabilitation

Client Registration Form

HT Animal Rehabilitation

htanimalrehabilitation@gmail.com

07969268797

www.htanimalrehabilitation.co.uk

Owners Name:

Owners Address

Telephone Number:

Owners Email:

Animal details

Animal Species:

Animal Name:

Animals address

Animal Age:

Animal Breed

Animal Sex/Neutered

Veterinary Practise:

Veterinary Address:

Telephone number:

Veterinary Email:

Reason for treatment/referral

Has your Vet seen your animal for this issue?

By completing this form you agree to HT Animal Rehabilitation terms and conditions.

- I give consent for my veterinary practice to share the above mentioned animal's clinical notes with HT Animal Rehabilitation

- I give consent for HT Animal Rehabilitation to discuss treatment and any concerns with my veterinary practice.

- I understand any new pathologie or lameness require a vet check before further physiotherapy/ rehabilitation treatment can occur.