Pre-Appointment Correspondence Request

Brown Veterinary Housecalls

Dover
Mesa, AZ 85205

(480)494-6034

www.brownvetservices.com

PRE-APPOINTMENT SPECIAL CORRESPONDENCE REQUEST FORM

for

Brown Veterinary Housecalls, Equine Acupuncture-TCVM & Soul Puppy Holistic Healing

PLEASE NOTE ALL GENERAL INQUIRY INFORMATION & NEW CLIENT REQUESTS ARE FOUND & PROCESSED DIRECTLY ON THIS SITE AT NO COST

Dr. Brown understands that choosing a veterinarian is an important process and that deciding to incorporate unfamiliar holistic modalities into a pets treatment plan may bring up questions. Dr. Brown has created three very extensive websites to help address such topics as it is not possible for her to personally respond to general inquiry questions nor is staff able to offer medical advice

IMPORTANT NOTE: This request form is for general information only, is not a veterinary consult or telemedicine service, does not include medical advise or pet specific medical questions and does not create in any way an active client/patient/doctor relationship. Dr. Brown and all state licensed veterinarians are not able to offer medical advice or prescribe medication or Chinese herbs without an active client/patient/doctor relationship by law i.e. official appointment for an in-person exam and consult to establish an active client/patient/doctor relationship.

This complimentary and/or paid* service has been created specifically to acknowledge and accommodate the phone and email requests Dr. Brown receives for "pre-appointment interviews" or "chats to see if a good fit" from pet owners that wish to have direct correspondence with Dr. Brown or remote staff prior to scheduling an official appointment for an in person exam and consult. A portion of the fee for these requests will be donated to NOTONEMOREVET an organization that assists veterinary professionals in dealing with burn out, compassion fatigue and suicide risk due to the demands of the profession.

DR. BROWNS WEBSITES & COMPLIMENTARY RESOURCES

Brownvetservices.com

Soulpuppy.net

Drbrownequineacupuncture.com

New Client Information Page

Special Correspondence Form

Please tell us which of Dr. Browns websites you were reviewing (required)

Brownvetservices.com (main site-housecalls)
Soulpuppy.net (TCVM office in downtown Mesa)
Drbrownequineacupuncture.com (mobile equine TCVM services)

Please choose from the following options. Regular business hours are Tues-Fri 11AM to 5PM CLOSED Sat, Sun, Mon & Holidays (required)

Complimentary Email response from Gabby
Prepaid Chat with technician Jim or Deb for $44/15min during regular business hours within 1 to 3 business days
Email response from Dr. Brown within 1 to 3 business days during regular business hours $88 for 15 min
Phone response with Dr. Brown within 1 to 3 business days during regular business hours $111 for 15 min

Name (required)

First Name (required)	Last Name (required)

Phone (required)
Phone Type	Phone Number (required)

Email Address (required)

Pets Name, Age and Breed (required)

Brief pet history/medical conditions of concern for which you are considering an appointment with Dr. Brown (required)

General Questions (required)

What specific questions do you have that were not answered or unable to find on the website that is not considered medical advice? (required)

Additional Space if needed

Additional Space if needed.

By checking this box I understand that this service is for general information only. I understand this is not a veterinary medical consult or telemedicine consult and that medical advice will not be obtained by law

By checking this box I understand that this service does not establish an active client/patient/doctor relationship and that an actual in person physical exam appointment with my pet is required to do so by law

I understand by checking this box that if not requesting a complimentary email that this is a prepaid nonrefundable fee for a one time correspondence service for general information and that general information can be found on this site at no cost

I understand by checking this box that this fee will not count toward any other services, is not the same as an appointment deposit and that this correspondence service and fee will not guarantee a future appointment with Dr. Brown

By checking this box I agree to prepay for this correspondence service via zelle, venmo or paypal. I understand that due to the number of requests received daily that Dr. Brown will not be able to respond to my request until payment is received.

Preferred payment options (required)

Zelle-send to 480-494-6034 or brownvethc@gmail.com
Paypal-send to drbrown@brownvetservices.com
Venmo-send to cmbrowndvm

A portion of this fee will go to NOTONEMOREVET: an organization that helps veterinary professionals cope with the demands of the profession in dealing with compassion fatigue and suicide risk.

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