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By checking this, it acts as my signature authorizing Veterinary Orthopedic Manipulation for my animal by Dr. Tonya Carswell D.C., C.V.C.P. The submission certifies that I do hereby release Dr. Tonya Carswell, D.C., C.V.C.P to perform VOM (Veterinary Orthopedic Manipulation), and Cold Laser therapy on my pet listed above. I realize that: 1) As with all medical and chiropractic procedure, this technique is being applied without guarantee of cure or promise of relief. In clinical practice, 7-9% of cases do not respond to VOM or Cold Laser therapies. 2) The VOM technology is inherently non-invasive and safe. To date no animal has been injured with this method of diagnosis and treatment. 3) The AVMA still regard VOM and Cold Laser experimental in the USA. 4) The undersigned has received written confirmation from their Veterinarian to have such pet(s) listed above receive treatment from Dr. Tonya Carswell, D.C. C.V.C.P. I wish to have the VOM Diagnostic and treatment Technology applied to my pet.
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