Your name:
Your address:
Your email address:
Your home phone:
Your cell phone :
How old is your
animal? Briefly
describe the problem
your animal is having:
How long has this been
a problem?
Has your animal seen his/her
regular vet for this problem?
No
Yes
Has the regular vet given you a
diagnosis? If Yes, please include.
Costs and Scheduling:
Most dogs and cats come to my house for treatments. Initially a new patient
exam and treatment will be done where a comprehensive history will be taken,
care recommendations made with an initial acupuncture treatment. The initial
patient initial consultation and treatment is $110. On-going treatments take
about an hour and include on-going holistic and veterinary care
recommendations. 24 hour cancellation notice required. Cancellations less
than 24 hours will be subject to a fee of $35.
What day and time is best for an appointment?
M
1st Choice:
Day:
Time:
 Any Day
 Or
 W
 F
PM
AM
2nd Choice:
Day:
Time
M
 W
Any Day
 Or
 F
AM
PM
To receive the earliest appointment available, please list any days/
times that you are NOT available in the next week. (this may include
days or times in which you are working or other times in which you
know that you will not be able to attend)
Anything else?
I will contact you via email within 2 business days. Thank you.
Dog and Cat Owners:

Thank you for contacting Integrative Veterinary Services.

It helps to know more about your animal to decide whether acupuncture is the
best treatment for your animal. Please complete the below form below and I
will contact you within 1 - 2 days. Thank you.
Dr. Aimee Witherspoon
25601 NE 10th Ave
Ridgefield,WA 98642

p: 360-887-2344
c: 360-601-7171

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Integrative Veterinary Services