New Client Information and Consent Form

Please fill out the following information before your appointment with Dr. Lauren. If you have multiple pets, please fill out a new form for each animal.  

Appointments are available during the following times:

Sunday and Monday: Closed

Tuesday through Friday: 11 am to 7 pm

Saturday: 11 am to 3 pm

Payment is expected in full at time of service. Cash, checks, and credit cards accepted.

**Please note that we will be closed from Friday, February 22nd through Monday, February 25th.  We will return during our regular hours on Tuesday, February 26th.  Thank you!**

In order to give all of our patients the care and attention they deserve, we are not currently accepting new clients. Please keep checking back for updates!

**If we have previously seen another animal in your household, please contact us directly to schedule an appointment**

To schedule an appointment, please call 520.979.7273, email PricklyPearVet@gmail.com or fill out a Contact Request Form.

 

**Please use the New Client Form below if you have ALREADY set an appointment with Prickly Pear Vet**

New Client Information and Consent Form
First Name*
Last Name*
Address*
City*
State*
Zip*
Email*
Phone*
Primary Veterinary Clinic
Primary Veterinarian
How did you hear about us?
Animal's Name*
Animal's Birthdate (mm/dd/yyyy)*
Species (dog? cat? horse?)*
Breed (Cocker Spaniel? Domestic Short Hair? etc)*
Color*
Sex*
Weight, in pounds (if known)
Please briefly explain your concerns or questions
I read the Consent and Payment Agreement below*
Electronic Signature*
Date*

I, the owner of the pet identified above, consent to the examination and treatment of my pet with acupuncture, and/or chiropractic, and/or herbs by Lauren Genow, DVM of Prickly Pear Holistic Veterinary Care, LLC. Acupuncture, chiropractic, and herbal therapy are considered to be a part of Complementary and Alternative Veterinary Medicine (CAVM). Acupuncture treatment techniques include but are not limited to the following: dry needling, electroacupuncture, aquapuncture, and moxibustion. I understand that complications of acupuncture are uncommon and include, but are not limited to: broken needle under the skin, needle ingestion, infection, and bleeding. Side effects of herbal therapy can include vomiting and diarrhea but these effects are rare and usually mild. I understand and am informed that in the practice of chiropractic therapy there are some risks to treatment, including but not limited to fractures, disc injuries, strokes, dislocations and sprains. I do not expect the veterinarian to be able to anticipate all risks and complications, and I wish to rely upon the veterinarian to exercise judgement during the course of the procedure, in my best interest, based upon the facts then known to her. ***By inputing my Electronic Signature above, I agree to pay any expenses associated with care provided by Prickly Pear Holistic Veterinary Care, LLC.***