AMC Referral Form - Animal Medical Center

Dear Veterinarians & Vet Practice Owners,

To ensure that your clients referred are serviced promptly, this form will facilitate the submission of a complete medical history required for referral. Please ensure that the reports are submitted completely.

This is completed by referring veterinary clinics only.

1Step 1: Download Form & Fill Up

2Step 2: Upload Required Documents

Please click the following icon to download AMC Veterinary Referral Form (PDF 197KB)

Veterinary Clinic Name *

Referring Doctor *

Clinic's Contact No *

Clinic Email *

Pet Owner's Name *

Pet Name *

Species *

Canine
Feline
Other

Upload Referral Form *

Click or drag a file to this area to upload.

Allowed files jpg png pdf doc docx
(*Max file size 2MB)

Reminder: Please complete every section in the form. Alternatively, you may submit the form via email to: admin@medivet.com.my / amc-hq@animalhospital.com.my

A completely filled-in referral form will ensure and help our vets to process your request without further delay.

Note: INCOMPLETE FORMS WILL NOT BE ENTERTAINED.

Please make an appointment ONE (1) WEEK prior to the consultation. Any emergency case, please contact us at +6013 431 5157 or +603 4042 6742 and speak to our Front Desk Officer for further assistance.