This form is exclusively for patients with scheduled appointments. If you do not have an appointment scheduled, call or text us FIRST.
972-468-9795

Initial Consult Submission

First name

Last name

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

Animal Name

Age

Sex

Color

Breed

Brief Description of what is wrong with your pet

*I understand that the state of Texas considers acupuncture, chiropractic and laser therapy to be alternative treatments. By clicking this box I agree that my pet can receive alternative therapies.

*I agree to receive text messages from Back in Motion Veterinary Services.

*I understand the initial consult is $160 (prepaid). Therapies are additional. Acupuncture $90, Chiropractic $65, Laser starts at $60, Shockwave starts at $100. If other treatments are recommended the cost will be discussed at the appointment.

*I understand Back in Motion does not offer general medicine and I need to maintain a relationship with a primary veterinarian.

*I understand the initial consult deposit is non refundable, and that there is a $50 fee for cancelling my appointment (or future appointments) with less than 48 hours notice.

Signature

Signature field is empty.

Initial Consult Deposit (Payment Required to confirm booking)

Initial Consult Deposit160

This form is exclusively for patients with scheduled appointments. If you do not have an appointment scheduled, call or text us FIRST. 972-468-9795

Initial Consult Submission

This form is exclusively for patients with scheduled appointments. If you do not have an appointment scheduled, call or text us FIRST.
972-468-9795