New Patient Intake Form

Initial Consultation Information

Duration: The appointment includes one hour of the doctor’s full focus and attention on your pet.
Comprehensive Assessment: We will focus on identifying underlying issues contributing to your pet’s symptoms.
Customized Plan: Based on the exam, a tailored treatment and/or wellness plan will be developed specifically for your pet.
Dual Medical Approach: Our doctors use both Western medicine and Traditional Chinese Medicine modalities to perform a thorough evaluation.
Estimates for services can be provided, and depending on schedule availability, some treatments may commence at the initial visit.

The cost for a new patient appointment is $350. A $125 deposit is required to hold your appointment and is due at the time of booking (appointments cannot be booked without a deposit). This amount will be credited to your account and reflected on your invoice.
The $125 deposit is refundable or transferable should you need to cancel or move your appointment as long as at least a 24 hour notice is given. If canceling with less than 24 hour notice, the deposit becomes nonrefundable.
Natural Healing Pet Care offers personalized care in a serene environment with the hope of uplifting not only the patients but also their caregivers. To ensure a tranquil and positive setting Natural Healing Pet Care is not equipped for surgical procedures, anesthesia or radiographs.

Thank you !

Client Contact Information

First Name

Last Name

Phone

Street Address

City

Postal / Zip code

Region/State/Province

Secondary Contact Info (Name, Phone, Email)

Patient Information

Pet's Name

Age or Date of Birth

Breed

Color

Name of Conventional Clinic and/or Doctor Name

Reason for Appointment

List Any Current & Past Diagnoses for Your Pet

Current Diet (pet food brands, human food, frequency, when current diet started)

List All Current Medications

What Diagnostics Have Been Performed?

Describe Your Pet's Response to Past Treatments

By checking this box, I acknowledge that the price for an initial consultation is $350 and a $125 deposit must be placed prior to the appointment.

By checking this box, I acknowledge that this is a holistic veterinary practice, and therefore we are not equipped for surgical procedures, anesthesia or radiographs.

We look forward to seeing you!

After Submitting Your Form

Due to a high volume of forms, we'll do our best to contact you within 2-3 business days following your form submission.
Please email your pet's full medical records from your general care veterinarian and/or any specialist(s) to naturalhealingpetcare@gmail.com - It is important we receive them before the appointment to allow ample time for the doctor to review them. Please include:
- Medical (doctor) notes
- Diagnostic results (blood work, urinalysis, fecal testing, etc.)
- Vaccine history
- Imaging reports and the images (X-Rays, MRI, CT)