Animal Behavior Network

Creating kinder, gentler experiences for pets

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- Recommending Behavior Services -

Request a contact to your client to explain and offer a Pet Behavior History Analysis.. DVM may also request a Behavior Consult with Dr. Tripp by calling Antech at 1-800-745-4725 Ext. 5
Hospital Name:	OPTIONAL
Attending DVM Name: (eg. "Mary Smith")
DVM Phone:
DVM Email:
DVM Fax:	OPTIONAL
Do you prefer to receive reports by email, phone or fax?
Is this the first time you have referred a case to Dr. Tripp
Client Information:


Client Name: (eg. "Mary Smith")
Client Phone:	specify:
Client Email:
Pet Name:
Primary Concern:
Species and Gender:
Other Comments

Important - Please Read Agreements

By submitting this form, I confirm that I retain the Veterinary-Client-Patient-Relationship for this pet and client and that I am requesting ABN to contact my client and offer this service (at no obligation). If my client chooses an Analysis, I understand that all behavior-related reports and recommendations for medical tests, prescriptions, and medical treatments will be sent to me by email or fax to add to my clients medical record, and that I may consult (at no charge) at any time with the ABN Veterinary Behavior Consultant and Veterinary Behavior Technician regarding recommendations for this case. My client will pay the Animal Behavior Network (ABN) $120 for the Analysis and a Consultation to explain it and answer questions (to save my time). If my client chooses additional behavior support services from ABN, I will receive regular updates on the behavioral progress of the pet and behavior modification plan.

I understand: *