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Home Exercise Plan Order Form

To receive an individualized Home Exercise Plan for your dog, or cat, complete the order form below, then submit payment.

The Home Exercise Plan will be sent to the email provided on this form, typically, within 72 hours of receiving the order.  Please allow additional time for weekends, holidays and periods of high demand.

* Indicates required fields to submit the form.

Prior to completing the order form, please note the following information:

- A Veterinarian diagnosis is required to receive a Home Exercise Plan

- Medical Records must be uploaded on this form to complete the order.  Medical Records stating pertinent medical history and            diagnosis are necessary to ensure appropriate exercises are prescribed.  Submitted medical records serve as Veterinarian                referral for Physical Rehabilitation - Home Exercise Plans.

- Based on your dog's diagnosis and physical rehabilitation progress, an additional Home Exercise Plan, or plans, may be needed

  for optimal physical rehabilitation.

- Home Exercise Plans are interactive digital files.  They provide an individualized exercise plan with written instructions or video 

  demonstrations of each exercise or therapy prescribed.  The plan allows digital/online tracking as rehabilitation progresses.  Home

  Exercise plans can also be printed as PDFs.

- If you have any questions about exercises or your dogs physical rehabilitation and progress, please contact your Veterinarian.

Client Information

Patient Information

Referring Veterinarian Information

Medical Record Upload

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