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Referral Form

Veterinary referral is required

Please discuss Acupuncture with your vet.
If they feel that it may be appropriate please ask them to fill out our referral form.
Adam will review the details and we will arrange an appointment.

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Online Referral Form

**Only to be completed by referring veterinary practices**

After filling in this form please forward history to adamrevitt@hotmail.com

Thanks for submitting!

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