(This form has been adapted and modified form the Companion Animal Behaviour Therapy Study Group [CABTSG] and was produced and approved after consultation with the Royal College of Veterinary Surgeons [RCVS])
If, for any reason, you prefer to complete this form as a PDF (either digitally or by hand), please download it here, & email it to: email@example.com, along with the patient's clinical history.
Please note: This form is for veterinary professionals' use ONLY.
By proceeding & using this form, you confirm that you are a Veterinary Surgeon or Registered Veterinary Nurse (completing the form under direction from an MRCVS).
(If you are neither of these, please close this page, & do not access the form - thanks!)
If you have questions, please just ask: firstname.lastname@example.org - I shall be happy to help.
Dear veterinary colleague,
Thank you for referring this case for behavioural assessment, management +/- modification/training.
I am happy to collaborate with you and the practice team in any way that is beneficial for our mutual client, both in my capacity as Veterinary Technician Specialist in Behaviour, ASAB-accredited Certified Clinical Animal Behaviourist, and as an RVN. I commit to always seeking input from you as/when appropriate; using only kind, ethical, positive and evidence-based methods of behaviour change; and never outstepping my professional capabilities. I will communicate with you re-this case following the first meeting with the client and pet, and continue to update you thereafter. Please do not hesitate to contact me regarding this case.
“Behaviour problems may arise both directly and indirectly as a result of concurrent or previous medical problems. Veterinary involvement is therefore essential in eliminating organic causes of the problem and prioritising the diagnostic and treatment strategy to be used in any given case. In order to safeguard the welfare of your patient and indicate your approval of referral, please complete the following form. Please note that until a case is released to another veterinary surgeon then you, as the client’s normal veterinary surgeon, remain responsible for the treatment, advice and any prescriptions given.” CABTSG.
CCAB Dog Behaviourist, dog trainer CCAB
Contact Linda! email@example.com