Page 1 of 1

Forms

Posted: Sun Feb 25, 2018 10:18 pm
by puppylove
We are expanding our services and adding an UWT. Past blogs gave me some great info on how to design the structure of room, visits, etc. One thing I am struggling with is wording on a clearance form from a rdvm. Initially we would like to authorize patients coming from other hospitals but are requiring healthy animals have a clearance from their vet. Does anyone have something they would be willing to share?

Thank you,
Missi

Re: Forms

Posted: Mon Feb 26, 2018 3:23 am
by lehughes
Hi Missi,

We have JUST created something similar. We have a proper referral / request for medical information for rehab cases... but this is the one we have created to catch the 'others'. I hope I can cut and paste it here:

Aquatic Exercise Clearance Form

Please note that this is not a referral, consent to treat, or request for medical information.
This is veterinary clearance, so as to allow _______________________________________
to engage in an aquatic exercise program.
Client Information:
Name: _______________________________________________________________________
Phone Number: _______________________________________________________________
Pet Information:
Name: _____________________________________ Age: ________________________
Breed: ______________________________________ Gender (circle): M F MN FS
Special Considerations: __________________________________________________________
____________________________________________________________________________________________________________________________________________________________
Services Approved (please check):
O Under Water Treadmill O Resistance Pool O Physio therapy services (if required)
Veterinarian Name: _____________________________________________________________
Clinic: ________________________________________________________________________
Signature:_____________________________________________________________________
Date: _________________________________________________________________________


I hope this helps!
Cheers,
Laurie

Re: Forms

Posted: Tue Feb 27, 2018 11:51 am
by puppylove
This is perfect! Thank you so much Laurie.

Re: Forms

Posted: Wed Mar 07, 2018 4:58 pm
by lehughes
My pleasure!!

Re: Forms

Posted: Mon Mar 12, 2018 7:22 pm
by niagaracanine
Hi Missi,
We have a swimming pool at our facility. For all our rehab cases we require a vet referral and will have completed a thorough rehab assessment prior to treatment which could include the hydrotherapy. However we do have clients bringing their dogs for swimming for fun and fitness which don't require a vet referral. What we insist on is a pre-swim check. We have the owners do a health questionnaire, we check heart lungs, skin and joints and take a medical history and make sure there are no bowel or bladder issues. This usually take about 15 mins and we charge $25 for that.
Barbara