ECG report request form

Please complete the form below and upload your ECG traces. We will send a report to you within one working day of receipt.

This form is for Veterinary Professionals to refer patients to us. (If you are a pet owner please speak to your General Practice Vet about being referred to Davies Veterinary Specialists.)

Cost £50.00 + 20% VAT (£60.00)

Important: Please ensure all traces supplied are clearly marked with information on: date, patient positioning, leads, calibration, paper speed and whether a filter was used.

Please remember to let your clients know we do reimburse the £200 if they hold an RSA insurance policy – read more.

Veterinary information

Owner information

Patient information

It’s easy to upload your files:

Step 1 - Upload a zip file containing all supporting files via We Transfer Click here to upload
Step 2 - Click the 3 dots next to the transfer button.
Step 3 - Select the ’Send as link’ button.
Step 4 - Click Transfer, then copy and paste the We Transfer link into the field below.
You can upload up to 2GB via We Transfer’s free service.

I agree to my personal data being stored (View Privacy Policy) I agree to being contacted by emailI agree to being contacted by phone

The personal data submitted via this form will be retained only for the purpose of responding to your question or concern, and will not be used for marketing purposes.

You must be 16 years old or older to submit a form.