Please help us prove your pet with a complete evaluation by taking the time to fill out this questionnaire carefully. If there is anything you wish to bring to our attention, which is not on this form, please note it in the comments section.
Authorization for Perform Physical Rehabilitation Therapy
I understand that the following are considered alternative forms of therapy:
In addition, I understand that all medicine, both alternative and conventional, run some inherent risk.
I understand that before my pet enters the underwater treadmill, he or she must urinate and defecate prior to appointment. If my pet urinates or defecates while in the underwater treadmill, I understand I must pay a $20 service fee per incident.
I authorize Everhart Veterinary Medicine to perform physical rehabilitation therapies on my pet. I acknowledge that no guarantee or assurance has been made to me as to the results that may be obtained.
