Direct Claim Application Form

For us to be able to process your Direct Claim, could you please submit the following form.

To finalise the direct claim arrangement, which is subject to approval, you will be required to pay a £500 deposit and a non-claimable/ non-refundable administration charge of £54.

To process your direct claim application, we require the application form to be sent back to us at least 48 hours prior to your appointment.

If your direct claim application is declined, we are happy to submit your claim following full and final settlement of your account. Please supply us with your completed claim form on the day of treatment following payment to enable us to start the process for you. If your insurance company is paperless, please inform them of the claim to initiate a link to be activated.

If your estimated treatment costs exceed the cover you have on your insurance policy, you will be asked to pay the difference in full when you come for your appointment. Equally, if your pet is hospitalised and receiving ongoing treatment with us which then exceeds your insurance cover, you will be contacted and asked to make an interim payment.

Once settlement has been received from the insurance company, any remaining costs will be deducted from the deposit held on account. Any balance of deposit, if applicable, will then be refunded.

Your details

Your pet's details

Insurance details

Clinical history


Please contact your insurance company as soon as possible, advising them of your referral to North Downs Specialist Referrals and leave authority for us to discuss your policy with them. In order to process your claim, we may also be required to share details of your pet’s treatment and history that we hold and by signing this form you understand that you are giving us authority to do this.

Proof of identity

You will be required to provide proof of identity when you come in for your appointment. This must be photographic ID, such as a driving license or passport.

Data protection

NDSR is GDPR compliant, and a copy of our policies can be viewed via our website or are available on request. Treatment will only be discussed with you or your nominated person(s) if permission is provided above.