Patient Update & Progress-Active

Brown Veterinary Housecalls

Dover
Mesa, AZ 85205

(480)494-6034

www.brownvetservices.com

Brown Veterinary Housecalls-Soul Puppy Holistic Healing-Mobile Equine TCVM

Active Patient Remote/Virtual Communication

Doctor and cat icon with heart


Complimentary

Two Week Post Appointment Email Follow Up 

Quick Question* i.e. medication/herbal dose questions

Update Only (no response) i.e. patient health status & treatment progress info


TeLeVET Time 

Q & A, Treatment management, New health concerns, TeLeHealth, TeLeMedicine, etc. *

PREPAYMENT REQUIRED

No refunds, transers or exchanges

Active Patients Only


*All virtual forms of communication with Dr. Brown are considered TeLeVET Time. Please submit this form within two weeks of your pets in person appointment date to receive a complimentary email follow up from Dr. Brown.  TeLeVET Time fees apply thereafter for Dr. Browns time & expertise. Quick questions are subject to TeLeVET fees at doctor discretion if more involved than yes/no or brief response regarding medication/herbal dosing etc. (not applicable for new health concerns). New health concerns require TeLeVET Time or an in-person appointment. Unlimited update forms may be submitted to keep Dr. Brown informed of patient health status & treatment progress (response not included). Dr. Brown will always respond via email during virtual office hours within 7 business days (Tues-Fri) or less pending chosen option below (closed Sat, Sun, Mon & Holidays-additional fees apply). For advanced communication via phone/text see concierge subscription options. Please note this is not an emergency response service. Thank you #notonemorevet

 Learn more

ACTIVE Patient Progress Form

VCPR-Veterinarian Client Patient Relationship
My pet is an ACTIVE patient with Dr. Brown via (required)

Brown Veterinary Housecalls
Mobile Equine Acupuncture-TCVM
Soul Puppy Holistic Healing (Mesa specialty office)


My pets most recent exam or acupuncture treatment with Dr. Brown (required)

Two weeks or less (complimentary response)
Monthly Schedule
1 to 3 months
6 to 12months
If greater than 12months your pet no longer has an active VCPR-please submit an in-person appointment request. Thank you


Pet Care Team
Has your pet been seen by another DVM, ER, Urgent Care, Specialist, Chiropractor, Corporate Telemedicine Service, etc. since your most recent appointment with Dr. Brown? (required)

No
Yes-records have been emailed to records@brownvetservices.com
Yes- records have NOT been submitted to records@brownvetservices.com


If yes answered above, please provide additional information (reason for appointment & treatment provided)

Progress Form Details
Purpose of Form Submission (Active Patients Only) No refunds, Transfers or Exchanges (required)

Two week post appointment complimentary follow up
Update only (no response i.e. patient health status or treatment progress info to keep Dr. Brown informed)
Quick Question (i.e. medication or herbal dosage question, labwork frequency question, etc.)
TeLeVET Time Virtual Office Hours response within 7 business days (Tues-Fri) $44/15min
TeLeVET Time Same Business Day Response (Tues-Fri) $88/15min
TeLeVET Time Saturday Response (closed/after hours fee) $128/15min
TeLeVET Time Monday Response (closed/after hours fee) $128/15min
TeLeVET Time Sunday (closed/after hours fee) $222/15min
TeLeVET Time Holiday/Summer/Spring/Winter Posted Closure Dates (closed) $444/15min


Prepayment Required for TeLeVET Time Responses (Active Patients Only) No refunds, Transfers or Exchanges (required)

Zelle via phone: 480-494-6034
Venmo via cmbrowndvm
Paypal Direct via drbrown@brownvetservices.com
N/A


Same Day/After Hours Response Request Submissions-please text scheduling at 480-648-4401 to confirm receipt of online request form and pre-payment & to alert Dr. Brown (required)

I understand Dr. Brown will only respond if I follow these exact instructions
N/A


Name (required)
First Name (required)
Last Name (required)
Phone (required)
Phone TypePhone Number (required)
Email address (required)

Pet Patient Info
Pet Name (required)

Species

Dog
Cat
Horse


Medication
Medications with Doses currently being given (for best service please do not write same as previous) i.e. X amount given X times daily (required)

Chinese Herbal Prescription
Chinese Herbals with Doses currently being given (for best service please do not write same as previous) i.e. X amount given X times daily (required)

Supplements
My pet takes the following supplements (required)

1. None
2. Glucosamine
3. CBD
4.Probiotics
5. Standard Process
6.Nordic Naturals
7.Slippery Elm
8. Other


Additional space for supplement details (please write numbers from above if more than one & provide details if others not listed)

Diet
Current Diet (for best service please do not write same as previous)

Appetite & Gastrointestinal Concerns
Appetite (required)

Normal
Decreased
Increased
Finicky
Nausea


Vomiting (required)

None
Frequent
Vomits Bile
Vomits Food
Regurgitation
Nausea
Occasional


Stools (required)

Normal
Soft
Diarrhea
Constipation
Staining to defecate
Fecal Incontinence
Mucous in stool
Blood in stool
Abdominal pain/Colic-horses
Gastric ulcers-horses


Additional space for Appetite or Gastrointestinal Concerns

Water Consumption and Urinary System
Water Consumption (required)

Normal
Excessive
Not drinking
Unsure


Urination (required)

NormalStraining
Blood in urine
Frequent Urination
Not urinating (if male cat blocked-seek emergency care immediately)
Unsure


Cardiovascular & Respiratory Systems
Heart & Lungs (required)

Normal
Cough
Sneeze
Reverse Sneeze
Heart murmur-stable
Congestive heart failure-stable
Respiratory distress (please seek emergency care immdiately)
Exercise intolerance
Asthma history-stable
Asthma history-flare up (please seek emergency care immediately)


Skin & Ears
Allergies (required)

None
History of allergies-stable
History of allergies-flare up
Licks feet
Uticaria/Hives-horses


Level of Itchiness (required)

None
Mild
Mod
Severe
Licks feet only


Ears (required)

No concerns
Shaking head
Scratching ears
Odor
Swollen ear flap (hematoma)
Red & Inflammed ear
Chronic otitis-stable
Chronic otitis-flare up


Additional space for Allergy & Otitis (ear) concerns

Neurology
Nervous System (required)

Normal
Seizure-first ever: please seek emergency care immediately
Seizure history-recent episode
Seizure history-stable
Head tilt
Circling
Paralysis/Paresis-new-please seek emergency care immediately
Paralysis/paresis-stable/responding to treatment
Wobblers


Additional space for nervous system concerns

Musculoskeletal System
Musculoskeletal (required)

Normal
Limping
Hindend Weakness
Swollen leg or joint
Tendon/Ligament Injury
Arthritis
Hoof abscess-horses
Back pain-horses
Laminitis-acute
Laminitis-chronic
Navicular
Shoulder pain-horses


Additional space for musculoskeletal concerns

Update & Progress Information (please be as specific as possible to avoid back & forth communication)

Questions or concerns for Dr. Brown relating to your pets most recent appointment (Please submit a TeLeVET Time form for new concerns or requests)

Additional Space/Quick Question(s)

Scheduling
I would like to schedule an in-person appointment for my pet (required)

Yes (please text the complimentary scheduling line at 480-648-4401 for best service)
My pet is already on the books
Not at this time


Traditional Chinese Veterinary Medicine (TCVM)
Prepaid service options for TCVM Patients (required)

Initial Herbal Consult with Prescription request
Herbal Re-evaluation request
Food Therapy- Basic request
Food Therapy Custom-request
Not at this time
Not applicable-my pet is not a TCVM patient


Complimentary Follow Up (within 2 weeks of in person appointment date): Dr. Brown will respond via email within 7 business days
Patient Updates only (response not included however Dr. B. may suggest an in person appointment or TeLeVET Time based on information provided)
Quick Question (yes/no or brief response): Dr. B will respond within 7 business days. If more involved than yes/no or brief response TeLeVET Fees apply

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