Sidney Carter, D.C.

702-703-1866  |  www.lasvegasanimalchiro.com
Chiropractic Care for Large and Small Animals

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YOUR CONTACT INFORMATION

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ADDRESS

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ADDITIONAL ADDRESS

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YOUR ANIMAL'S INFORMATION

Neutered/Spayed*
YesNoDon't Know

YOUR VETERINARIAN'S INFORMATION

I do not have a veterinarian at this time.My veterinarian's office is out of state.

ADDITIONAL INFORMATION

HOW CAN WE HELP? (Please be sure to include when any issues began and how your animal received the injury if applicable.)

HOW DID YOU HEAR ABOUT US?

ADDITIONAL COMMENTS

ANIMAL CHIROPRACTIC CONSENT

YES - I understand that Chiropractic Care IS NOT intended to replace traditional veterinary care, but is considered an alternative therapy to be used concurrently and in conjunction with my Veterinarian’s care.

YES - I certify that my animal has had regular, traditional veterinary care, and no limitations, no restrictions or contra-indications for chiropractic care are placed upon the animal. The animal is now being treated by my list Veterinarian.

YES - I understand that Dr. Carter will describe the procedures and explain, to my satisfaction, the purpose for performing them and the risks involved with them. I realize that there can be no guarantee as to the animal’s condition or the outcome of any procedures.

YES - I certify that I will been open and honest with Dr. Carter as to any and all other examinations, diagnostic tests, diagnoses, and treatments for my animal’s condition.

Policies

Welcome and thank you for choosing Las Vegas Animal Chiropractic! Your choice ensures your animal will receive excellent treatment and care. Dr. Carter has been practicing animal chiropractic in the Las Vegas valley for over 13 years. His mobile practice is unique by offering in-home visits to quickly maximize your animal's health. Before the first visit, Dr. Carter will consult with your veterinarian to ensure he can provide treatment during your initial appointment.

  • The price for the first consultation, evaluation, and treatment is $129.
  • Follow up visits within one calendar year are $99.
  • An additional small animal at the same location is $45.

Please schedule appointments with our client ambassador, D'anna, via phone or text at 702-703-1866. Dr. Carter allots a 2-hour appointment window to allow for adequate appointment and commute times.

Travel Fee:
While we will prefer not to charge a travel fee and will work with you to schedule your appointment when Dr. Carter is in your area, if the appointment is not on Dr. Carter’s scheduled route, a $60.00 travel fee may be assessed. You will be told in advance if a travel fee will be charged.

Cancellation Policy:
In order to keep our mobile chiropractic practice efficient and affordable, we require at least 48 hours notice of cancellation of any appointment. If you do not contact D'Anna, via phone or text at 702-703-1866 to cancel your appointment at least 48 hours in advance, you will be charged a $45 cancellation fee. Reminders will be sent prior to your appointment. If Dr. Carter arrives to your appointment and you are not home, there will be a $99 no-show fee assessed. If you have any doubts about being able to meet in the allotted two-hour time window, we suggest you call D'Anna at least 48 hours prior to your appointment time to reschedule for the next time Dr. Carter has availability in your area.

Dr. Carter reserves the right to cancel or reschedule your visit due to inclement weather or unforeseen traffic events.

More information and an updated schedule can be found at Facebook (Las Vegas Animal Chiropractic) or the webpage at www.LasVegasAnimalChiro.com.

We look forward to meeting with you and providing chiropractic care for your animal.

YES - I understand that multiple visits may be necessary to determine the proper course of treatment.

YES - As the owner / guardian of the animal(s) described on this form, and being eighteen years of age or older, I hereby authorize Dr. Sidney Carter to treat my animal(s).

Submission

We will contact you as soon as possible, during normal business hours, after receiving this information.

STANDARD PROCESS SUPPLEMENTS

We would be happy to evaluate your pet for Standard Process Supplements and provide a recommendation based on the nutritional needs of your pet.

Prior to purchasing the product, I want to ensure you are seeking regular veterinary care for your pet and are aware of any underlying conditions your pet may have.  Supplements are only recommendations and are not to be used as a replacement of any type of veterinary care. To make sure each product is appropriate for your, please inform us (1) about other medications or products you are using, (2) any known medical conditions or known contraindications, and (3) if the animal is pregnant or breastfeeding, or might become pregnant.