Patient Registration Form
This form is for new clients of Ceola Reece Veterinary Physiotherapy to register their animal/s for physiotherapy care.
If you have any questions or concerns, please contact Ceola directly:
Please provide important initial information about the animals you wish to register with me for physiotherapy.
How many animals are you registering with me today? If you are registering more than 2, please submit the form then fill it out again with the other animals details.*
Please provide details of your animals veterinary practice.
Legally, all patients must be registered with a Veterinary Surgeon before they can start physiotherapy. Is your animal/s registered with a vet?*
Declarations and Important Information
Please read the following sections carefully as they provide important legal considerations relevant to registering your animal for physiotherapeutic care with Ceola Reece Veterinary Physiotherapy.
If you have any questions or concerns, please contact Ceola directly:
In accordance with the Veterinary Surgeons Act, I may need to get veterinary consent from your vet before we can start physiotherapy with your animal. Do you consent to me contacting them to organise this?*
To provide high quality veterinary physiotherapy care, I like to maintain regular communication with your vet, including sending reports. Do you consent to this?*
Do you agree to follow the payment terms and cancellation policy found in my Terms and Conditions on my website?*
Would it be okay if I used images and videos of your animal on my website, social media and for educational purposes? I will of course always treat these with the upmost respect and decency.*
