Referral Form

For referring veterinarians, please complete the form below to expedite the referral process.

For any URGENT cases, urgent hospitalisations or emergency critical care (ECC) that requiring immediate attention, please DO NOT use this form. Please call our 24 hr direct line at 2915 3999 for fastest assistance.

Owner / Pet Information

Example: 77778888

Referrer

Example: 77778888

I have informed the pet owner that I’m referring the case to CCVG and I have obtained their consent appropriately to share their personal data with CCVG for this purpose.

Details

Emergency?
Requested Services

Disease Information

Please do not leave this section blank or write "see history". Even a brief case summary helps ensure proper case management and quick response.

Please attach relevant medical records below

including medical history, laboratory results and imaging results.

Maximum 6 files.
20 MB limit.
Allowed types: pdf, docx, png, jpg, jpeg, xlsx.

* If your patient requires immediate transfer, please call us at 2915 3999 after submitting this form.

 

You can find out how Mars and its affiliates (https://www.mars.com/made-by-mars(open in new tab)) collects and processes your data, contact us with privacy questions, and exercise your personal data rights via the Mars Privacy Statement (https://www.mars.com/privacy(open in new tab)).

 

We’d like to keep you up to date with exciting promotions and new product developments from Mars and its affiliates (https://www.mars.com/made-by-mars(open in new tab)).

I am over 16 years old, and would like to receive these from:


 

I understand that I may change these preferences at any time by contacting  [email protected](open in new tab)


 

From time to time, we may use your data for research to enhance our product and service offerings. You can find out how Mars Petcare and its affiliates collects and processes your data, contact us with privacy questions, and exercise your personal data rights via the Mars Privacy statement (https://www.mars.com/privacy(open in new tab))

CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

© 2026 Mars, Incorporated and its Affiliates. All Rights Reserved

Join our Community!
Sign up (opens in new window)