ACTIVE VCPR REQUIRED TO PROCEED: By checking this box I confirm that my pet is an active patient of Dr. Brown (VCPR=in person exam within last 12 months) or an active client with preapproval from Dr. Brown for a new pet in household
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My pet is an active patient via
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Email Address
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Pets Name
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Please list current diet and all medications/supplements your pet is currently taking (required)
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This condition or concern is (required)
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Brief overview of main concerns or questions. (required)
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My pet is (required)
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My pet has (required)
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My pets activity is (required)
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My pet is (required)
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Please use this for additional space if needed. Be sure to include when concerns started. The more detail the better to avoid back and forth emails
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Additional Space if needed.
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If this is a third party communication request for Dr.Brown to speak with specialist, trainer, etc regarding an active patient or to review documents provided by third party, please list name and contact information with authorization below
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Third Party Contact Info, Authorization and Release
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Pictures and any new medical records or test results are very helpful
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Have additional records or pictures been submitted via email to records@brownvetservices.com or text?
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By checking this box I understand this is not an emergency response service
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By checking this box I understand Dr. Brown bills for her remote time and expertise in 15 min increments at current TeLeVET Time hours and rates (subject to change without notice)
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By checking this box I agree to PREPAY for the first 15 min as chosen below along with any additional time invoiced
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Response Options (email only) (required)
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Holiday Closure Dates (posted on sites) additional response fees. Excludes Christmas Eve, Christmas Day, New Years Eve, New Years Day (required)
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PRE-PAYMENT REQUIRED: Options (for ACTIVE patients only-any payment received from NONCLIENTS will be CHARGED a transaction and return fee) (required)
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By checking this box I understand that if my pets condition can not be addressed or worsens that I must schedule an in person housecall or Soul Puppy appointment or go to the nearest full service veterinary clinic or emergency clinic
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Thank you for choosing Brown Veterinary Services for your pet care needs.
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Active Patient Progress Form