CLIENT INFORMATION FORM

(Use TAB between fields)

Phone
Phone
Include name/age/occupation/relationship
e.g. pet sitters, housekeepers, relatives, friends. Include name/age/occupation/relationship
Include name/age/species/breed/when acquired
Include name/age/species/breed
VETERINARIAN
HOUSE

PAYMENT POLICIES

Payment is expected at or before your Initial Behavior Consultation. I will accept cash ($5 discount), check ($5 discount), or credit card at the appointment. If you would like to pay via Venmo (@sfpetbehavior) or PayPal (keelydvm@sfpetbehavior.com), please submit payment at least 24 hours before your Initial Behavior Consultation . Please remember to include Additional Fees, if applicable, in the total cost of your Initial Behavior Consultation. Email keelydvm@sfpetbehavior.com with questions.

It is required that you complete a Client Information Form and Behavior History Questionnaire online at least 24 hours prior to my visit. Links will be provided in your appointment confirmation email. If these forms are not received, your appointment will be automatically cancelled. Email keelydvm@sfpetbehavior.com if you have problems with the forms.

If you need to cancel your appointment, please let me know as soon as possible and at least 72 hours prior to your appointment so that another client can be seen. Email keelydvm@sfpetbehavior.com at your earliest convenience if you must cancel.

SERVICE RATES (rates subject to change after 1/1/2019)

  • Initial Behavior Consultation (plus Travel Fee if applicable)....………..$375* (90 minutes plus Treatment Plan)

  • Additional pet (per pet)....................................................………..…...$245

  • Follow Up Behavior Consultation (plus Travel Fee if applicable)……...$255* (1 hour plus Summary)

  • Follow Up Phone Call...........................................................………....$45 (20 minutes plus Summary)

ADDITIONAL FEES if applicable

*Out of San Francisco County Travel Fee**...................$55**

**Additional Travel Fee if >40 miles (from 94127)........$45

DISCOUNTS

$5 discount for cash or checks

Thank you for taking the time to complete the Client Information form. This information will allow our appointment to proceed much more smoothly. I look forward to helping improve the lives of both you and your pet. 

Warmly, 

Dr. Keely Commins