• Multiple Animal Patient Intake

  • Format: (000) 000-0000.
  • For Massachusetts residents, a referral is required prior to animal chiropractic care. Have you had your vet fill out our referral sheet/sign off?*

  • Animal Information

  • Health History

  • Check the symptoms/ conditions that your animal(s) have or has had in the past*
  • Have any of your animals ever bit, kicked, attacked, or injured another animal or human?*
  • What preventatives / Rx / Supplements do you currently use on your animals (check all that apply):
  • What type of care have you used on your animals in the past?*

  • Owner Consents

  • Informed Consent about animal chiropractic:

    I, owner of the animal described above, and being 18 years of age or older, understand and authorize the following: 

    1. Their Best Life Animal Chiropractic / Dr. Meaghan Cavallaro is a NBCE Board Certified Chiropractor that has completed advanced training in the field of animal chiropractic through Health Pioneers Institute, an American Veterinary Chiropractic Association Approved Post Graduate Program, Chicago/Naperville, Illionois. She is a Certified Animal Chiropractor.

    2. Dr. Meaghan Cavallaro is not a veterinarian 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 adjunct/therapy to be used concurrently with a veterinarian’s care and recommendations. 

    4. Dr. Meaghan has explained the scope of care and described the procedures that will be performed on my animal, or will do so on our first encounter. I understand those procedures and have had an opportunity to ask questions about them, or will be able to do so before we start treatment.

    5. Dr. Meaghan has explained and I understand the risks involved with animal chiropractic care and supportive modalities (such as laser therapy, Graston Technique, Cupping and Kinesio Taping) to my satisfaction, and I realize that there can is no guarantee as to the nature of my animal’s condition or outcome of any procedure (or complete resolution of symptoms). 

    Consent:

    I hereby authorize Their Best Life Animal Chiropractic, Dr. Meaghan Cavallaro, to treat my animal with veterinary spinal manipulative therapy- animal chiropractic and/or rehabilitation as well as complimentary modalities.

     

     

    Photo/Video Release:

    I understand that my animal may be photographed and/or videoed for clinical, case study,  and/or marketing use, and give my permission to have said images used on Their Best Life's 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 my (owner’s name) will be kept private. Said media is /will be the property of Dr. Meaghan Cavallaro, but if at any time I would like images of my pet removed from online platforms, I can submit a request in writing to Their Best Life Animal Chiropractic and it will be taken down within 7 days of the date the request was received.

    Veterinarian consent(s): In the state of MA I will obtain a signature on a referral form from my vet. prior to starting care. 

    I consent to allow Dr. Meaghan to discuss my pet/animal's care with their veterinarian as medically necessary, or as requested by their vet. 

     

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