Veterinarian referral form

ZENFULdog Cognitive Canisport Training

Monkland, Ontario

info@zenfuldogtraining.com

613.870.1997

We offer individualized Canine fitness programs, cold laser therapy and laser acupoint protocols. Our fitness programs are tailored to each dog taking into account their age, weaknesses, and sports they enjoy to support longer healthier lives. Our cold laser is geared to compliment our fitness programs and canisport athletes while our laser acupoint protocols add calming benefits to our dogs overall lives while complimenting our canine sport partners. Your client is seeking to join a fitness program and/or have their dog enjoy a cold laser protocol. This form is to verify if their dog has any restrictions or limitations.
Client Name
Dog Name
E-mail
example@example.com
Breed
Phone
DOB

MonthDayYear
Date
Weight
Sex
Referring DVM
Clinic Name
E-mail
example@example.com
Phone
Diagnosis if applicable
Recommended Restrictions/Limitations
Additional Information/Comments:
Would you like e-mailed reports of your patient's progress and/or fitness programs?

yesNo
Veterinarian's Signature

Clear
Date

MonthDayYear
Date
Fitness Program Options

Targeted FitnessGeneral Conditioningpuppy programsenior programbeginner programsport dog programstrong dog program
Cold Laser Therapy Protocols

Muscle Recovery - improve performance and speed up recovery time after exercisePain ReductionSoft Tissue InjuriesStress/Trigger Points
Laser Acupoint Protocols

Relieve painReduce fatigueDecrease FearDecrease anxietyStrengthen immune systemHelp with breathing IssuesImprove Range of motionImprove GI issuesCalming effectDecreases Behavioural issuesDecrease confusionStimulates brain function
Please Note: ZENFULdog offers canine conditioning, fitness, cold laser therapy treatment and dog training. We do not diagnose injuries, illness, or disease. If any issues are observed we will advise Clients to seek veterinary care. All dogs who receive cold laser therapy have been diagnosed and approved for treatment by their veterinarian. All dogs who participate in the Canine Conditioning program after an injury or illness must have veterinary clearance. When concerns are noted, clients will be directed to seek appropriate care from their veterinarian.Targeted Fitness program is to focus on a specific weakness, this is NOT physical rehabilition.
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