ECG report request form

    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 £65.00 incl VAT

    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.

    If you experience any problems making an online referral, please call us on 01582 883950 or email

    Veterinary information

    Owner information

    Patient information



    Has the patient been neutered?

    NeuteredNot neutered



    It’s easy to upload your files:

    Step 1 - Please upload all relevant supporting files via We Transfer. Please include any relevant information including; full medical history, most recent test results, images and any other supporting documentation for the patient. 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

    Davies Veterinary Specialists is part of Linnaeus Group Limited. The personal data submitted via this form will be retained only for the purpose of responding to your question or concern. We will not share this information with other companies for their marketing purposes. For more details on how we use your information please see our privacy policy.

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

    Linnaeus Veterinary Limited trading as Davies Veterinary Specialists 01582 883950

    ©2022 Davies Veterinary Specialists