Please tell us which website you used to access this form as Dr. Brown has three branches to her practice (required) OWNER VERIFICATION
Owner Verification (required) Additional Information if submitting this form for an elderly family member or disabled person Temperament Disclosure (please note Dr. Brown does not offer sedation for TCVM services) (required) Additional Information regarding your horses temperament TCVM Equine Service Options
Housecall or Barncall Choices (TCVM only-general medicine not included) (required) Major Cross Streets (required) Complex or Community Name Building Number or Letter Apartment or Unit Number or Letter Gate Code if applicable Horse Barn or Stable Address and Name Email
Email address (required) Horse Information
Pet #1 Name (required) Age: Years, Months Breed: Color Sex Is your horse current on vaccines? Has your horse had a full blood panel in the past 12 months? Reason for appointment/main concerns (required) Duration of above concerns/conditions Goals of appointment/treatment? (required) Please list any history of chronic medical conditions. Please list any previous surgery Please list all medications your horse is currently taking Please list any herbs or supplements your horse is taking Current/Previous Veterinary Practice Phone number or City and State of previous vet. Special requests or conditions? How did you hear about our services? If referred by an individual, who may we thank for the referral? Additional Pet Information
Pet #2 Name Type of Pet Additional Pet Information
Pet #3 Name Type of Pet NATURE OF SERVICE
Dr. Brown sees patients by scheduled appointment only during regular business hours based on location and availability. Please note this is not an emergency, on-call or overall concierge service. Due to the nature of this service and territory covered, it is recommended that all pet owners be familiar with local vets and emergency clinics in their area should the need arise. Concierge service options available via paid membership packages on a case by case basis pending availability. Soul Puppy is a TCVM specialty office and is not a full service clinic. DEPOSITS/PAYMENTS/CANCELLATION POLICIES
A minimum deposit of $50 per horse is required to confirm all approved new client appointments which will be deducted from the invoice total. Information on how to pay deposits will be sent via email invitation for approved requests only. Payment is due at time of services rendered via cash, credit card, zelle or venmo. There is a $50 48 h notice cancellation fee, $75 24 hour notice cancellation fee, $125 same day cancellation fee if less than 12 hours notice (prepaid acupuncture packages automatically forfeit a treatment visit) and a $200 minimum no show/not home fee including forfeit of any prepaid urgent care/emergency/extended travel fees & deposits (prepaid acupuncture packages automatically forfeit a treatment visit). AGGRESSIVE PET POLICY
For safety purposes Dr. Brown has a no aggressive pet policy. She reserves the right to decline a physical exam if a pet displays aggressive behavior, such as growling, snarling, lunging or attempting to bite. If the pet is deemed to be aggressive by the veterinarian, the client agrees to pay in full, the house call and travel fee and a veterinarian consultation fee. Dr. Brown does not accept pets with a history of aggression or in need of sedation for exams. Dr. Brown reserves the right to refuse service at her discretion. CLIENT POLICY
Dr. Brown and staff are happy to assist you and your pet in a mutually enjoyable and respectful working relationship with healthy boundaries as outlined on this website. Dr. Brown is a proud supporter of NOTONEMOREVET and reserves the right to refuse service at her discretion. DIRECT CORRESPONDENCE WITH DR. BROWN
Direct correspondence with Dr. Brown is available via In Person Appointments, TeLeVET Time Remote Support Services & Concierge Package Services. TeLeVET fees apply after initial complimentary follow up per In Person Appointment. Please note unlimited direct correspondence with Dr. Brown via email/phone/text is not included once an appointment has ended. Please request TeLeVET Time for continued support. Online forms & email is the preferred method of communication due to the nature of this practice. Active clients will receive a private number for complimentary text scheduling. This number is for scheduling purposes only (no medical texts please). Thank you PRACTICED POLICY AGREEMENT
I have read the Deposit/Payment/Cancellation, Nature of Service, Correspondence with Dr. Brown, Aggressive Pet and Client Policy and agree to the terms. (required) I understand that I will receive an email from scheduling@brownvetservices.com regarding my appointment request within 1 to 3 business days otherwise this form did not process correctly and we did not receive it. All required fields must be entered. I understand I must contact my current/previous veterinarian directly and have my pet(s) medical records & vaccine history emailed to records@brownvetservices.com for review. Please note requests are waitlisted until records received. IMPORTANT: Submitting this form completes step one (new client form). Please immediately go to step two (medical records). Requests are wait listed until medical records (step two) are received for review. Please respond to our emails for best service. Complete the verification below
Processing ....
Equine Acupuncture-TCVM Services via Brown Veterinary Housecalls 
