Pre-Appointment Correspondence Request

Brown Veterinary Housecalls

Dover
Mesa, AZ 85205

(480)494-6034

www.brownvetservices.com

Pre-Appointment Chat Request Form

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

This is a Special Request Form for Pre-Appointment Correspondence with Dr. Brown, Jim or Deb

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.

Brownvetservices.com

Soulpuppy.net

Drbrownequineacupuncture.com

NEW CLIENT INFORMATION PAGE

This complimentary and/or paid* service has been created for pet owners who are unsure of which route of care (Western vs TCVM vs Integrative) is best for their pet and to accommodate the requests Dr. Brown receives for "pre-appointment interviews" or "chats" and emails from pet owners that wish to have direct correspondence with Dr. Brown prior to scheduling an official appointment for an in person exam and consult.

A portion of the fee will be donated to NOTONEMOREVET

IMPORTANT NOTE: This service 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.

*Fees subject to change without notice.

Special Correspondence Form

Name

First Name	Last Name

Phone
Phone Type	Phone Number

Email Address

Pets Name, Age and Breed

General Questions

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 chat with Jim 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.

Please choose from the following options. Regular business hours are Tues-Fri 9AM to 5PM (required)

Complimentary Chat with technician Jim during regular business hours when available within 5 to 7 business days
Prepaid Chat with technician 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

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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