Laparoscopic Neutering Request Form

This form is only for use by veterinary surgeons to arrange routine laparoscopic neutering for a healthy bitch. For other endosurgery referrals, including laparoscopic gastropexy, please use our regular referral form. Referral forms for other disciplines, and word versions of referral forms, can be found here.

If you have a pet who you wish to be seen at South Devon Referrals, please contact your veterinary practice and ask them to contact us to arrange referral. We will then contact you to arrange a convenient appointment time.

You will receive a copy of the online request form by email: if you do not receive this then please contact us by other means to confirm we have received your request (please check your spam folder).

All items marked with an asterisk (*) are required. Please check they are completed and once you have submitted the form ensure you receive the message “Your message was sent successfully, and we have sent you a copy. Thank you.” which will appear under the submit button.

Laparoscopic Neutering Request for Healthy Bitch
Practice details


Client information

Patient information

History



Heart disease/ PacemakerRenal diseaseKnown adverse reactions to medicationsSurgery within the previous two monthsPregnancy or pseudopregnancyEndocrine disease, bleeding disorder, neoplasiaEpilepsyNone of the above


Upload relevant history or other files

Maximum upload size is 2 Mb per file. If you have larger files to send please email them directly.









All items marked with an asterisk (*) are required. Please check they are completed and once you have submitted the form ensure you receive the message “Your message was sent successfully, and we have sent you a copy. Thank you.” which will appear under the submit button.