Skip to content
Text me
(613) 799-2728
About
Services
FAQ
Get A Quote
Vet Referral
Contact
About
Services
FAQ
Get A Quote
Vet Referral
Contact
Contact Me
Have questions? Reach out to me and I will get back to you with more information.
Text me to make an appointment at (613) 799-2728, or complete the form below.
Name
Name
Phone Number
Email
(Required)
Enter Email
Confirm Email
How can we help you?
I was wondering about availability and rates. I need help with the following:
CAPTCHA
Referral Form
"
*
" indicates required fields
RDVM Name / License
*
Clinic Name
*
RDVM Email
*
Client Name
*
First
Last
Client Email
*
Client Phone Number
*
Patient Name
*
Patient Species
*
Canine
Feline
Date of Birth
DD slash MM slash YYYY
Age
Please enter a number from
1
to
100
.
Presenting Complaint - Diagnosis
*
Submission
*
SUBMISSION OF THIS FORM hereby refers the aforementioned client to Nancy Couillard (the "Veterinary Technician Specialist in Physical Rehabilitation") and agrees to provide indirect supervision to the Technician relevant to this engagement, the costs of which shall be borne by the Animal Owner. A report will be provided following the initial consultation, as well as after each visit within three business days. If there is anything noted of any concern, the client will be referred back to the regular veterinarian for a follow-up.
I agree
CAPTCHA
