Appointment Request Form 2026

FEE SCHEDULE

As of November 1st, 2026

Visit Type	Consult (First Visit)	Established Patient	Barn Call Fee (Within 40 Miles)
Equine	$150	$120	$40
Canine	$100	$80

*Veterinary authorization required for all new animal consults

**$2/mile for barn calls >40 miles

Owner's Name

First NameLast Name
E-mail
example@example.com
Phone Number

Area CodePhone Number
Select Species
Enter details for Other* into the comments below
Breed
Animal's Name

Call/Barn NameRegistered name (if applicable)
Animal's DOB:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Select M/F
Veterinarian's Name & Email

DVM/Clinic NameEmail
Reason for Requesting Appointment:
Visit preference:
Provider preference (if applicable):
Who may we thank for the referral?
Thank you for your submission!

Once this form is completed, please allow up to 48 hours for us to contact your DVM and request authorization to start care. We will contact you for scheduling following receipt of the authorization back to us. Please text us at 605-389-3089 with any questions you may have & we look forward to serving you!
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