Use this form to tell me about your consultation needs. This is not a guarantee of service. I will review your request to determine if we will be a good fit!
Consult Request Form
Your Information
Name
*
First Name
Last Name
Are you a veterinarian?
*
Yes
No
Soon to graduate
Practice Name
Optional
Practice Location
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
Optional
Consultation Needs
Please tell me a little about yourself and what you are looking for
*
Which species will we be consulting about? (select all that apply)
*
Dairy Cattle
Beef Cattle
Goats
Sheep
Alpacas
Horses
Pigs
Other
Estimated Frequency of Cases/Questions
Please Select
Daily
Several times a week
Several times a month
Other
Preferred Method of Contact
*
Phone call
Text
Email
No preference
Consultation Fee Information and Payment
The consultation fee is charged in advance on a monthly basis and is non-refundable. I allow you to set the rate based on your anticipated frequency of needs, and I will work with you if these needs change!
Your suggested monthly consult fee:
*
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( X )
USD
You will not be charged until I accept the consult
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Submit
Should be Empty: