Referral Form For Dog Owners

Please fill in this form as an owner to refer your dog to CS Hydro-phyiso Ltd for treatment.

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Pet Details

Please estimate if uncertain

Treatment Details

How Long Have You Been Visiting CS Hydro-Physio Ltd?
CS Hydro-Physio Has Two Clinics, One In Theale And One In Tilehurst. Which Is Your Preferred Treatment Clinic?
This allows us to ensure we book your dog at the most convenient clinic for you.
If You Are Travelling By Car, Are You Happy And Comfortable Getting Your Dog In And Out Of The Car And Into Clinic?
We are able to assist at our end as needed, so this just helps us plan for your dogs session

Insurance Information

Is Your Dog Insured?
If no, please leave the rest of this section blank

Owner Information

Owners Address

Veterinary Information

Local Vets Name
Veterinary Practice Address
Have You Been Referred To A Specialist Referral Centre

Terms, Condition's & Disclaimers

Please Follow This Link and Carefully Read and Agree To The CS Hydro-physio Ltd terms and Conditions for Treatment.

Please Read Carefully and Agree To The CS Hydro-physio Ltd terms and Conditions for Treatment as linked above.
Nuts in Clinic - We occasionally use dog safe peanut butter in our clinics for some dogs. Do you or anyone in your household/immediate circle have a nut allergy that we need to be aware of?
History of Seizures - We use a dog safe muscle and joint relief gel on some dogs in clinic. This product contains Wintergreen which has been linked to seizures in some cases. Do you, your dog(s) or anyone in your immediate circle have any seizure disorders that we need to be aware of?
At CS Hydro-physio, we take pride in the quality of service and care we deliver, as well as the achievements of our dogs. We occasionally share these accomplishments on social media platforms, emails, and our website. CS Hydro-physio reserves the right to use video footage and take photographs during sessions for promotional purposes. Please indicate your authorization for each media platform you are comfortable with.
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