Thank you for the opportunity to care for your livestock. Please complete this form prior to your first appointment. We look forward to serving you! -Dr. Jake & Taunya
(540) 299-COWS // //
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Email *
First and Last Name *
Farm Address(es) *
Mailing Address (if different) *
Phone Number *
Is anyone else authorized to make appointments for your animals? Please list full name(s).
Who can we thank for referring you? *
Farm Species *
If individual animal(s) are to be seen, please list their name, age, breed, and sex.
(optional) We offer our clients to keep a card on file for their convenience as a payment option. This card is charged automatically after each appointment. Would you like to keep a card on file? If yes, you will receive a credit card authorization form by email shortly after submitting this form.
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Payment & Policies
PAYMENT: Please note that payment is due when services are rendered before we leave the farm. Ruminant Reproductive Services, PLLC accepts cash, card, or check. We also offer the option to leave a card on file for your convenience.

PAPERLESS: In an effort to improve efficiency and reduce waste, our business is paperless. All invoices, receipts, and records will be sent to the email you provide. If you do not receive an email shortly after your appointment, please check your spam folder or contact us to ensure delivery. Paper copies are available upon request.

HOURS: Our business hours are 8am-5pm Monday-Friday and Saturdays by appointment. We also offer after-hour emergency services for our current clients.

AFTER HOURS EMERGENCIES: If you have an emergency after hours, please call (540) 299-COWS to leave a message on our emergency line and Dr. Jake will call you back shortly. Please note that texts and Facebook messages are not monitored after hours. Please call for emergencies so we can best serve you.
I have read and understand the Payment & Policies section above. *
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