I, owner of the animal described below, and being 18 years of age or older, do understand, substantiate and authorize the following: 1. Companion Animal Chiropractic LLC employs licensed chiropractors and/or veterinarians who have attended at least 226+ hours of post graduate education specific to spinal manipulation. 2. Chiropractors employed by Companion Animal Chiropractic are not veterinarians, unless otherwise noted, and cannot take responsibility for the primary care of my animal. 3. Chiropractic care is not intended to replace traditional veterinary care, but is considered a ‘complimentary therapy’ to be used concurrently and in conjunction with my veterinarian’s care and recommendations. 4. The chiropractor employed by Companion Animal Chiropractic has explained to me the scope of care and described the procedures that will be performed on my animal. I understand those procedures and acknowledge that they agree with the American Veterinary Medical Association’s (AVMA) description of veterinary spinal manipulative therapy or animal chiropractic:
Veterinary chiropractic is the examination, diagnosis and treatment of non-human animals through spinal manipulation and adjustments of specific joints. The term ‘veterinary chiropractic’ should not be interpreted to include dispensing medication, performing surgery, injecting medications, recommending supplements or replacing traditional veterinary care. While sufficient research exists documenting efficacy of chiropractic in humans, research in veterinary chiropractic is limited. Sufficient clinical and anecdotal evidence exists to indicate veterinary chiropractic can be beneficial. It is recommended that further research be conducted in veterinary chiropractic to evaluate efficacy, indications, and limitations. The assurance of education in veterinary chiropractic is central to the ability of the veterinary profession to provide this service.
Licensed chiropractors who have earned sufficient certification through a state-approved program may perform animal chiropractic when animals are referred for care by their veterinarian.
5. The doctor has explained the risks involved with animal chiropractic care to my satisfaction, and I realize that there can be no guarantee as to the nature of my animal’s condition or outcome of any procedure.
I understand that my animal may be photographed and/or videoed for clinical and/or marketing use and give my permission to have said images used on the Companion Animal Chiropractic LLC website and/or social media accounts. I understand that only my pet’s first name and image may be used for this purpose, and personal information including the owner’s name will be kept private. Said images are the property of Companion Animal Chiropractic, LLC. If at any time I would like images of my pet removed from these mediums, I can submit a request in writing to Companion Animal Chiropractic LLC and it will be taken down within 7 days of the date the request was received.
I hereby authorize Companion Animal Chiropractic LLC and their licensed providers to treat my animal with veterinary spinal manipulative therapy- animal chiropractic and/or rehabilitation. I certify that my animal has had routine, traditional veterinary care, and that my veterinarian has referred me to this service. My current veterinarian is: