Existing Clients Notes

Covid-19 recheck case clinic update Winter 2023:

It is very important to do your follow-up as directed by your clinician, currently by telephone or Zoom but, due to state and prescription law, will require a brief “curbside exam” at least every 12 months. For most rechecks, to avoid technical (e.g., Zoom) delays taking up your valuable appointment time, we suggest telephone-only rechecks but you can always e-mail us a picture or two or the link to a video (please do NOT e-mail us huge image files but if much over 1 MB please upload to a cloud account like Drop Box, OneDrive or Google Drive and just e-mail us the link to your video for the doctor to access during your recheck time). Remember that you MUST be an active client/patient (defined as following treatment plan follow-up directions and having your next appointment booked on our schedule!) for us to be able to approve medication refills. Medication refills for inactive patients (not following recheck directions or cancelling and not rescheduling promptly) will likely delay or may even deny refill requests for your pet. “Help us help you” by doing your part and remaining an active client😉! Although we love to see our clients/patients “in person” and miss being able to do so, we have already been doing phone rechecks with clients whose pets have been seen “in person” within the last 12 months for several decades now since not all of our clients and pets can come in-person to each appointment (may live hours away, pet that does not travel well, clients’ have tight schedule, etc.) and telemedicine rechecks are very effective in managing behavior cases when “in person” appointments are not practical. For those pets who are due for an “in person” exam (for example coming up on 12 months since the doctor has last seen your pet “in person”), we can combine with telemedicine appointment with a very brief “curbside exam” in front of the doctor’s house in Carmel Valley when the doctor is in town seeing clients to re-establish the legally required Veterinarian/Client/Patient relationship (VCPR), which allows all California veterinarians to diagnose and prescribe treatments including prescription medications. Since we plan the “exam” part for after the phone recheck, scheduling your next recheck and taking payment are all completed, we advise planning to be in front of the doctor’s Carmel Valley home office about 30 minutes into your recheck time. Some clients find it easier to come a bit early, park nearby on the street and do the phone part from their car (especially if have to drive a distance or not comfortable doing phone recheck while driving) so that they can just hop out with their pet for the brief “curbside exam” about 30 minutes in😊

If you decide to postpone vital rechecks versus continuing follow-up by phone or telemedicine appointments, please note that you are doing so against your specialist’s medical advice.

For those that have not scheduled/rescheduled their next recheck (“inactive patients”) please let us know ASAP if you intend to take advantage of these telemedicine options so that we can work together to get you on the doctor’s tight schedule (rechecks typically are scheduled 4-12 weeks out so best to schedule at time of your previous appointment to have date/time options). Clients that put off scheduling their recheck until just days or weeks before due are likely to need to actively keep checking in with our office to see what other clients may have rescheduled and opened up a slot we can fit you in to (“crap shoot” method) since sometimes clients only let us know a couple of days before their scheduled appointment that they will not be able to honor their reserved appointment time. If you are coming up on the 12-month exam requirement (or past due) it is VERY IMPORTANT to get the recheck/curbside exam scheduled & completed while the doctor is physically in San Diego area since he can do phone-only appointments but not actually “examine” patients while out of the area for several months of the year these days and cannot legally refill meds without that annual “exam.”

Please let us know the preferred phone number where we should call you for your phone recheck appointment if you have more than 1. Payment is due at the appointment taken during the appointment (see P.S. below). If you do not pay your bill promptly, billing fees will be added to your balance as noted in our practice intake forms/policies since this takes time away from patient care.

Please check our website for future updates or inquire with our office (e-mail best since little time to “chat” on phone these days but leaving voicemail can work) if you have remaining questions about your upcoming appointment not found in e-mails we have sent you.

We are sorry for any disruption in our “normal” specialty practice services and our clients’ schedule with these steps but they are for all of our health and it is vital for us all to work together to make it through this difficult time until robust population (aka herd) immunity can be achieved with vaccines (safely and effectively or, alternatively, hopefully surviving infections and without experiencing “long Covid” ongoing symptoms lasting months to possibly years) and virtually all of our clinic clients are fully vaccinated for Covid. When/if we do start seeing patients again at the clinic or by housecall “in person,” we will only be offering this option to clients with proof of completed vaccinations including any boosters following national and local public health guidelines. As always, as a private specialty practice, we reserve the right to refuse services to anyone not following our practice policies.

We are sorry for any unavoidable disruption in our “normal” specialty practice services and our clients’ schedule with these steps, but they are for all of our health and it is vital for us all to continue working together to make it through this challenging time. We, the Behavior Specialty services, are actually very well situated to continue to help our clients/patients with telemedicine compared to most other boarded specialties since we can A LOT with telemedicine (“talking behind your pet’s back” 😉) without needing to actually see the pet “in person” each recheck.
We hope you and yours stay safe (and sane) during this time😊

P.S. Please note that clients that choose to pay by credit or debit card (we accept Visa, Mastercard or Discover) will pay a 4% convenience fee (also be sure to let doctor know this ASAP when we start to allow sufficient time to check out via credit card as it takes longer). To avoid this additional modest convenience fee, simply pay using VENMO=(@Patrick-Melese), Google Pay or Zelle or, if you can coming “in person,” you can also pay with cash or check.

“We confirm appointments as a courtesy; it is still your responsibility to stay aware of the time and date of your appointment or cancel/reschedule with sufficient (48 business hours) notice to avoid incurring late cancellation fees.”

Patrick Melese DVM, MA, DACVB and staff
Board Certified Veterinary Behaviorist