Behavior History Form - Dog / Cat
EXERCISE:
MEDICAL CONSIDERATIONS:
ANY ACCIDENTS IN HOME:
DOES YOUR DOG?:
YesNo
We require a $60 deposit to be made when you schedule your appointment. The deposit is non-refundable
If Dr Foote has not physically examined my pet, the video chat is a Teletriage/teleadvice consult. Dr Foote will not be prescribing medication, making a diagnosis or prognosis about my pet. Dr Foote will collaborate with my primary care veterinarian who will be the one to prescribe medication, make a diagnosis or prognosis about my pet.
Telecommunication with the veterinary staff is limited to the hours of availability determined by the veterinary staff.
* Payment is due upon receipt of invoiced services. A $5 MINIMUM OR A 2% MONTHLY CHARGE IS ADDED TO ALL BALANCES. * Any unpaid balance over 60 days will be send to collections, with all fees for collection services added to the balance for services.