New Patient Form

Name

First NameLast Name

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Please allow 1-3 business days to hear back from us after submitting this form. Please also carefully read the polices below. Please write the word "star" in the box if you have read this. Thank You!

Patients name, breed, color, sex, age, weight

Major complaint and duration of problem:

Diagnostics/Treatments already done:

Diet (specific brand and all treats, extras)

Current medications and Supplements

Appetite

Thirst

Feces

Urine

Temperature Preferences

Personality

Please provide the name and email address for any Veterinary Clinic that has previous records for you pet. Please ask your Veterinary Clinic to send records pertaining to this problem to soundanimalwellness@gmail.com

Policies: Payment is due at time of service. We happily accept Cash, Check, Venmo or PayPal. Sound Animal Wellness can accept Visa, MasterCard, American Express and Discover with a 3% swipe/processing fee. Venmo: @amanda-panno-1, PayPal: awohlwen@yahoo.com When we are providing mobile care please allow a 15 min window for our arrival time to account for traffic, etc. If we will be more than 15 minutes late then we will let you know. Please request prescription and herb refills 7 days before you will run out of medication. This needs to be done via email. If herbs are ordered for the patient, payment is due prior to ordering and most of the time they will ship directly to your house. If you cancel an appointment 48hr or less there will be a $45 missed appointment fee. If you cancel an appointment less than 24hrs notice there is $90 missed appointment fee. If we are en route or have arrived at your house and there is a no show or cancel the full amount for the appointment is due. We can respond to email and texts during business hours. Please allow 1-3 business days for responses. We are closed Sat, Sun, Wed and all Holidays. Please reserve texting as needed for scheduling. All medical questions requiring a response outside of your appointment time are subject to a possible $45 Telemedicine fee. All new clients can ask questions as needed during the first 2 weeks after their first appointment for no charge.