Client Information and Release Form
Thank you for the honor of working with
you and your pet. We trust you look forward to the exciting teamwork ahead as we do. The information on this page
will help establish guidelines and expectations and prevent misunderstandings. Please read it carefully and
feel free to bring any comments or questions to your appointment.
You must agree to these terms with
your signature on the release form is at the bottom of this page.
PROTOCOL AND FEE STRUCTURE
If you are like most of us, one of the first things you want to know is how all this works and
the fee structure. So, since we are all thinking of helping your loved one as the most important thing, let's set up
the foundation for our teamwork to make it easier for you to plan, and to assist in the process.
My practice differs from
the usual veterinary office in that the main service I provide is my expertise rather than conventional services
like surgery and radiographs. For these services you will be referred back to your local/conventional veterinarian as
The first appointment is quite extensive, running an average of 45 -
90 minutes. Following appointments generally last 10 - 30 minutes. The time between appointments
is usually three weeks to three months, and can be more frequent in acute states. The total length of time
needed to treat most chronic disease cases is two months to one year, depending on the difficulty of the case. My fees are laid out in detail in
the fee schedule.
I take payment
for phone consults in the form of credit card (Visa or MasterCard only) . I take
payment for in-clinic appointments in the form of credit
card (Visa or MasterCard only), cheque, or cash .
My practice of medicine provides a very different
experience from conventional veterinary medicine and it is my opinion that this form of therapy can be used to treat
a broader range of problems than those treated conventionally. However, the medical modalities I use are not magic.
Like conventional medicine they cannot resolve every problem successfully. You can, however, expect the
- My very best effort in
treating your pet.
A firm commitment to continually advance my skills and my
My most accurate prognosis for your pet at the end of the
Extensive after hours emergency coverage by myself or by another qualified homeopathic veterinarian.
Case treatment coordination with your local/conventional veterinarian.
for second opinions or referral to other homeopathic or conventional veterinarians as I see fit for the best care of
Homeopathy, nutrition, and natural supplements as the primary basis for treatment regardless of the nature of your pet's
problems or the conventional diagnosis, prognosis, or usual protocol for treatment.
Your responsibilities are as follows:
Monitor your pet well and keep good notes. This is essential. The treatment decisions made at each appointment and, therefore, our degree of success depends
2. Help coordinate treatment
between your local/conventional veterinarian and us openly and honestly. We look
forward to working with your local veterinarian. We must all work as a team for the good of your loved one. After all, medicine
is a service profession. We are all here to serve you and your pet.
3. While we strongly encourage you to actively participate in the decisions in your pet's case,
please do not administer nor discontinue any medications or supplements without consulting us first. This includes all
services offered by your local/conventional veterinarian for routine matters and emergencies. This greatly helps to avoid
problematic complications. We say this not to discourage you, but to invite you to use our experience in coordinating the
use of other modalities with homeopathy correctly, effectively and safely. Again, we eagerly welcome input from you and your
local/conventional veterinarian. To help insure a smooth case, just consult us first.
4. Be on time for appointments to help keep us on schedule.
For your first appointment it is most helpful to have the following information:
An account in your own words of your pet's condition and history.
Type or print
neatly using only one side of one page. Summarize and/or use bullet
points. Rambling narative is not helpful.
o A brief record from a recent veterinary exam indicating a diagnosis. Ten pages max.
Any recent test results.
A photo of you and your pet. These photos are kept with
the medical record and I look at them with every appointment.
list of all medications and supplements currently being used. Include their dosages. If you have an in-house appointment,
bring the list and the meds/supplements themselves.
We prefer that you bring all of
these things with you for your first appointment, or mail them if you have a telephone consultation. If time is
short you may fax your information to 845/338-9875 or email it as a .jpg or .pdf file to firstname.lastname@example.org, but please limit the number of pages to ten or less. Documents must be received two
business days in advance of the appointment if Dr. Yasson is to review them prior to the appointment.