What to do When an Associate Vet QuitsJan 25 2024
It’s the nightmare moment that every practice owner dreads. When an associate vet quits, it throws the entire clinic into chaos. Suddenly, workloads double overnight, responsibilities like on-call hours go from difficult to grueling, and the pressure can end up driving a larger staff exodus. It’s both a symptom and a cause of larger issues in a clinic. When an associate vet quits, it throws all of the existing problems at a hospital into stark relief. So how can we respond? How do we make it through in the short term, and how can we rebuild over time? 1. Cut back for now It’s not an easy decision to make, but reducing the amount of cases that your clinic handles for a short period can help you to make it through the initial struggle without burning out the rest of your staff. This is especially important for small clinics, where losing one associate has significant impacts on the other DVMs. For one clinic that lost an associate to maternity leave, the response was prioritizing the most important cases. They cut back their overall operating hours slightly and blocked off emergency slots for urgent same-day concerns. This meant handling less of the smaller, day-to-day wellness appointments and nail trims, but it allowed the clinic to continue operating with a smaller staff and provide the most vital care. One other benefit here: prioritizing emergency cases allows your clinic to see the patients that will drive the most revenue. It might sound cynical, but this is an important consideration when an associate vet quits. According to The Vet Recruiter, six months of trying to hire an associate can lead to $200,000 in missed revenue. Anything you can do to recapture revenue in the meantime will be vitally important for your clinic during these rough months. 2. Bring in virtual tools Losing an associate drives up the amount of work for everyone in your clinic, but it has an especially intense impact on your remaining DVMs. For busy clinics where staff is already feeling overwhelmed, that can be devastating. The goal, then, is to find ways to fill in the gaps. The upside here: you’ll likely find that there are better processes for some of your existing operations. When an associate vet quits, it can reveal inefficiencies, and the resulting struggle can drive clinics to make long-term investments in their day-to-day procedures. It’s not a great experience, but the result is a healthier clinic. For your remaining DVMs, offering telemedicine can be one key way to streamline things. It makes simple rechecks quicker without taking up an exam room. DVMs can also use tools like Talkatoo to help with your day-to-day tasks. For the rest of your team, move any labor that doesn’t need to be done in-clinic out of the waiting room. Dr. Rachael Kuhn has found that using Jotform can be a great way to have clients complete check-in paperwork before they ever arrive at her practice. Similarly, if you can move any client communications off of the phones, email and live chat are generally more efficient and streamlined, since they can be handled asynchronously. We cover the concept in more detail in this post, but work that can be done virtually includes: Scheduling appointments Follow up calls Rx refill requests Triage Call back reminders Check-in forms Taking deposits/pre-pay While these steps don’t immediately impact the workload of your DVMs, they can help to reduce the amount of chaos within the clinic, and the knock-on effect is a more stable atmosphere overall. Simply put, it’s the difference between pulling away techs to handle phone calls and having them focus on supporting the doctor. Speaking of support staff… 3. Use your support staff efficiently For many practitioners, being told to better utilize their techs prompts an eye roll. Everyone knows that this part of the team shouldn’t be doing reception work. The trick is figuring out how to best utilize your staff within the context of your specific practice. As a starting point, your assistants should be doing nail trims, suture removals, and other similar appointments. From there, you can consider segmenting your CVTs to focus on different parts of your operations. One approach is to split this team into hands-on clinical work and client-facing work. The clinical side handles blood draws, diagnostics, anesthesia, and bandage changes. The client-facing side takes care of chronic illness rechecks (like thyroid issues, diabetes, etc.), nutrition consultations, new puppy client education, discharge, case triage, vaccine booster appointments (excluding rabies), and assists with telehealth. The goal is to clearly break down roles so your DVMs can then focus on sick pets, urgent appointments, and surgery. Prioritizing efficiency when an associate vet quits can make all the difference. Look for any redundancies and anywhere that roles lack clarity. Even small steps forward here will help your staff to focus on providing gold-standard care, rather than administrating day-to-day issues. 4. Rethink on-call A pet’s health doesn’t follow a 9-5 schedule- should its access to care? After hours support is vital for clients, and it’s a non-negotiable for any clinic that wants to provide top-tier medicine. The problem is finding a solution that works for both your team and your community. On-call hours are exhausting and one of the leading drivers of burnout. It’s entirely possible that the struggle of balancing on-call with a day-to-day work schedule drove your associate to quit in the first place. So there’s a key tension here: more and more consumers are demanding support outside of a clinic’s usual hours, but finding DVMs that are willing to work on-call is really difficult. Luckily, this situation has a clear solution: GuardianVets. Our team of credentialed veterinary technicians support your community after hours, triaging cases and only contacting your DVMs based on your protocols. We make it easy to offer 24/7 care to your community. Even if your team isn’t on-call, additional support outside of your regular hours can help your clinic to retain clients after an associate vet quits, as well as making it easier to build appointments into your schedule. Remember: when an associate vet quits, your first priority should be supporting and retaining your remaining staff. That means working especially hard to build a healthy environment, even as things get intense. GuardianVets is the partner you need. Learn more here.
Who Supports Your Clients After Hours? (And How?)Dec 7 2023
One of my clients posted the photo at the top of this page to my clinic’s Facebook back in 2016. It was a tongue-in-cheek bit; a joke about how Jax, the dog, would drag his owner to the vet because he misses us. It’s a photo that I’ve been looking back at recently. The context of the image is so important because it could very easily tell a very different story. It could be an image of a pet waiting outside because help was unavailable. It could be a client feeling lost and uncertain with nowhere to turn. I’ve been thinking about the accessibility of care and our responsibility to both our patients and our teams. How do we balance our need for work-life balance with customer demand for care outside of standard clinic hours? How do we look after the needs of both our teams and our clients? Who is there for our patients when we can’t be? In this article, I’d like to look at the different ways that clinics meet the needs of their clients and patients after hours and talk a little about the approach that I take at my practice. Do your clients want after-hours care? In short: yes. If your clinic offers on-call hours, you’ve probably experienced this demand first-hand. The health of a pet doesn’t follow a standard schedule, and for many people, the majority of the hours they spend with their pets are in the evenings. If they’re going to notice an issue, there’s a good chance that it will happen when your clinic is closed. For new pet owners in particular, after-hours care is a really important draw in choosing a veterinary clinic. They generally don’t know whether an issue is significant enough to require immediate attention, and that can make them particularly anxious about the health of their pets. We’ve all heard stories of first-time pet owners rushing to the emergency room after their dog vomits, or when their cat won’t stop scratching an itch. The peace of mind that comes with knowing that their veterinary team is available to answer questions is hugely important to this group in particular. What are the options? The landscape for after-hours care can feel pretty bleak. Generally, the pressure is on the pet owner to figure out their options in an urgent situation. Here are a few ways that a late-night call to your clinic can play out. 1. Voicemail only The client calls with an urgent concern and reaches a voicemail that directs them to the emergency room. This takes an already difficult situation and adds an additional level of stress. If they are calling your clinic, that likely means that they aren’t sure if the situation they’re dealing with is truly emergent. Now they need to assess how urgently the animal needs care and whether they can afford an expensive visit to the ER. 2. Paid triage If a client can’t reach you, they’ll likely turn to the next available care network. Often, this is a triage service that can assess the clinical symptoms and direct the client to the appropriate care. Here’s the catch: these systems are pricey and require an account. Best case scenario, the client pays a significant amount of money to learn that they don’t actually need to go to the emergency room. While these measures can help, they’re a bad experience for a client in their hour of need, and they largely exist outside of your relationship with the patient. 3. On-call Traditionally, the approach to after-hours care was simple- make sure that someone from your clinic is available to support callers during late-night crises. Offering on-call hours keeps treatment in-house, allowing for continuity of care for the animal, as well as retaining revenue that might otherwise be lost to the ER. More and more clinics are struggling to maintain on-call hours, though. It’s just too hard on staff and has been directly linked to higher levels of burnout, lower job satisfaction, and a higher risk of physical health issues. Many associates simply don’t want to work a full day in-clinic, then spend their evenings answering calls that may or may not be true emergencies. For the clinics that do offer on-call, there’s a high volume of non-emergent calls interrupting their evenings, adding to the strain. How I handle after-hours care To start, I’ll quickly summarize the major details about my practice. I’m a solo DVM and practice owner with a support staff of two vet assistants and one customer service representative. We’re open from 8-5 Monday, Tuesday, Wednesday, and Friday, and we serve a community both within our small town and the surrounding areas. That leaves a lot of time that I’m not available when my clients have concerns. That’s why I work with GuardianVets to provide care for my community when I’m not around. When my clinic is closed, our phones forward directly to the GuardianVets team. A staff of credentialed veterinary technicians triages the calls, directing truly emergent cases to the ER, while encouraging others to book the next available appointment. For GV, the question is never “if” a patient needs to be seen. Instead, it’s just a question of how soon the animal should come in. The benefit? First, my clients can always reach someone in their time of need, at no additional cost to them. They don’t need to create an account or access any external service- instead, they just call my normal clinic number. They have peace of mind in knowing that a team is there for them, even when I can’t be. On my end, it’s incredibly freeing to know that my clients have someone to turn to when they have questions. I don’t need to offer on-call, but they can still get access to care when they need it. Cases that would have unnecessarily ended up in the ER are instead retained as appointments in my clinic, which recaptures a lot of revenue that would otherwise be lost. As a solo practitioner, GuardianVets allows me to provide care far beyond what I’d be able to otherwise, meeting client demand without overwhelming myself and my team. If your clinic is struggling to balance client demand for after-hours care, remember that you don’t need to do it alone. Learn more here.
The Moments that Make Us Better Veterinarians—A ConfessionNov 29 2023
By Holly Sawyer, DVM Those are pearls that were his eyes, Nothing of him that doth fade, But doth suffer a sea change, into something rich and strange… -Shakespeare, The Tempest When I graduated veterinary school in 1999, I thought with startled satisfaction, “I’ve arrived. I have achieved THE dream. My calling, my career, and my identity are set.” I headed off into the wild blue sea of private practice, expecting a straight-line voyage toward a sunset forty years in the future, as yet unaware of the ceaseless currents that propel medicine forward and the rogue waves that submerge you long enough to change you forever. Pain Like every other grad who headed straight into general practice, I stepped out of the Ivory Tower and tripped headfirst into “the way things are really done.” Cats were often boxed down with straight Iso for neuters. If pre-op injections were used at all, they consisted of atropine and [big: read 0.5 ml/cat] doses of acepromazine to ensure a docile induction. Add a squirt of butorphanol in there, given a solid 3-4 hours prior to surgery, and we felt pretty good about ourselves. At best, we used ketamine/valium like water; at worst, we used speed to flush stinging abscesses, clip painfully melting hot spots, and otherwise get ‘er done. Analgesia, far from being considered essential, was instead frowned upon. The prevailing wisdom in the real world was that pain inhibited overactivity, thus decreasing complications. With thinking like that, morality became a close friend to the status quo. I practiced this way for a good seven years. Yes, I felt terrible when a dog stood hunched and trembling, unwilling to lie down after abdominal surgery. But that would pass, and this was safer than using drugs we didn’t trust or keeping controlled drug logs we didn’t understand. The patients just had to endure for a little while longer before they were back to their old selves. I did not recognize my first paradigm shift in practice until it was well upon me. I’m not an early adopter by nature; neither were the owners of my practice. There were murmurings of a seismic shift in general veterinary practice at CE events. Anecdotal stories flourished from close veterinary friends in bigger cities. Veterinary Information Network, still in its relative infancy, saw an explosion of discussions on the topic. The upheaval was all about analgesia. It wasn’t just gaining popularity. It was the new standard of care. The body of evidence in favor of proactive pain control soon towered over every general practitioner, blotting out the sun. Our next step was clear. If we wanted to call ourselves good veterinarians, we needed to order morphine for dogs and buprenorphine for cats. That was the beginning for us. Our protocol soon expanded to include polypharmacy, nuanced timing of administration, and a growing focus on pre-op bloodwork and intra-op IV fluids due to the use of injectable NSAIDs. All of this happened because pain control was not only the best medicine physiologically, but it had unequivocally earned its place on the moral high ground as well. I felt…released…as if I had been breathing through a mouth gag for seven years and could finally fill my lungs. This was wholly right and good. I didn’t realize how wrong the old way was until it was held up in contrast to the new way. And I didn’t just give pain meds to my patients. I became a veterinarian who was ardently proactive about pain control. In a flash, I progressed from doing a new thing to embracing a new identity. I was changed—and proud to have been made better. Fear When Fear Free came around, I was in fact a fiercely ardent early adopter. I was recently asked why I believe in Fear Free. After some soul searching and mental sifting, the answer came to me in a flash. It was the giraffe. For those of you who have taken the Fear Free modules, do you remember that slide? It shows a giraffe munching lazily on a bucketful of lettuce and carrots as the zoo handler calmly trims a front hoof. The next slide shows the quintessential WWE photo of three vet techs sprawled on the treatment room floor, pinning a 70-pound dog to the ground, as a fourth tries to clip the toenails. I saw those slides juxtaposed together, and I felt shame. Shame. I had been on that treatment room floor, getting raked in the belly by a flailing back leg or pinning the dog’s head to the linoleum as foam bubbled through the blue nylon muzzle and anal gland juice spurted out the other end. Or worse, I had simply told the vet techs and assistants to get the nail trim done and then left the treatment area altogether, leaving them to obey or fail. Seeing that giraffe (who was entirely too big to bully) allow a hoof trim in such peace felt like a slap. I could no longer accept the excuse, “This is just the way things are done.” I had seen a better way. I bought peanut butter and canned cheese, pretzels and paper plates. I sent home pre-visit sedatives. I did new things, not just to do new things, but because I had changed my identity. I had become a different veterinarian. I had become better. Availability A move to a different state provided an opportunity to transition out of private practice and into a management position for an after-hours veterinary triage company. One second, I was wearing the white coat; the next, I was on the other side of the exam table. At every visit to my local clinic, I have done my best to support the veterinary team. I bring cookies and write thank you notes and accept delays with a friendly smile. I know what it’s like to wear their shoes. But I am also getting an exquisite feel of the pet owner’s shoes. I live in a rural area. I chose this; I must own it. But it presented me with a singular crisis when my adult Golden Retriever sloughed his gut for no good reason one night at 2AM and dragged himself outside during a winter blizzard to die. I had to decide between hazarding a 90-minute drive through the storm to the nearest emergency vet or muddling through the night on our own. My boy looked bad. Bad bad. But I didn’t want to die in a ditch on a desolate, frozen highway either. I called the emergency facility to give them a heads up that I might be heading in, but my fear of the blizzard won. Angus made it, thanks wholly to the 2L of SQ fluids I had in my home stash that bought us time until my local clinic opened six hours later. But it was scary, and I was a professional with resources. It is a hundred times worse for the regular pet owner. Through the triage company, I’ve heard pet owners calling their clinic in a furious panic but leaving the call calm and grateful, with a plan and some semblance of control over their circumstances. It’s all because the veterinary technician walked them through life-saving first aid and then directed them to the on-call doctor or closest ER clinic. I know the power of these calls firsthand. They can be miraculous. If I were still in private practice, I wonder if hearing one of those calls for the first time would be a sea change moment for me, a transition from the old way to the new. Would it stand shoulder to shoulder with my boss’s announcement that we were ordering morphine for the first time? Would it hit me like the giraffe eating her salad? Is continuity of care—giving your clients after-hours access to advice and direction while you sleep—your next opportunity to embrace a new identity and become a better veterinarian? Only you can say.
5 Tips for Managing Veterinary Stress (with Dr. Shawna Garner)Nov 24 2023
You don’t need me to tell you that it’s a difficult time in the veterinary world. You probably don’t need to see any statistics about the difficulties in hiring and maintaining staff, and I imagine you’ve heard plenty about burnout. So this week we’re going to try something a little different. I want to take a look at how one solo DVM maintains work-life balance and takes care of herself, even when things get hectic. Dr. Shawna Garner owns and operates a small clinic in her hometown in central Illinois. She serves both the town and the surrounding area, and maintains a small staff of three employees. It’s a lot to juggle, and she walked me through the ways that she manages stress and maintains a healthy work-life balance. Dr. Shawna is the host of our new show, the VetHealth podcast. Alongside her tips for handling mental and emotional health, our first episode explores the toolset she uses to manage her clinic, her advice for young DVMs just entering the profession, and the broader conversations we need to be having in the VetMed world. You can find the whole episode here. 1. Take a beat As a starting point, Shawna recommends setting aside time for mindfulness in whatever form works for you. For her, that’s meditation, but the same process can take a lot of different forms. Relaxing hobbies like knitting, painting, and yoga can all be helpful ways to destress outside of the clinic. During the day, simple breathing exercises can help reduce stress, increase blood flow, and keep you focused. The 4-7-8 technique involves inhaling for four seconds, holding for seven, and exhaling for eight. It’s a small practice that you can maintain throughout the day. Getting out of the clinic, either to take a walk or just sit in your car for a couple minutes, can also give you the space you need. Generally, Shawna recommends taking a beat and refocusing when your stress level starts going up, though she recognizes that can be difficult for associates at a busy clinic. 2. Intentionally aside set time to detach Shawna doesn’t do social media on Sundays- she calls this “anti-social” Sunday. The focus here is on unplugging and connecting with herself and her family. During that time, her phone is only for making calls. It’s not easy to step away from social media, though, even for a single day. The Jed Foundation recommends turning off push notifications, setting your phone screen to grayscale, and deleting social media apps to help in cutting back screen time. 3. Let it go Shawna recommends picking your battles and recognizing the parts of a pet’s health journey where you aren’t in control. Rather than trying to change a pet owner’s mind about treatment or diagnostics if they can’t afford it, Shawna steps back, respecting and supporting their decision. The pet owner is the decision maker, and Shawna knows that taking too much ownership over individual pets is emotionally draining. Here’s how she describes the situation: “A lot of times, veterinarians will take on a patient personally… they want to do absolutely everything and if the pet owner can’t, they feel the guilt.” Long-term, holding onto that guilt can lead to compassion fatigue and burnout. Similarly, when she leaves the clinic, Shawna makes a point of separating herself mentally. That might mean reading, playing video games with her son, or walking outside for thirty minutes to an hour. It’s a different kind of letting go, but the focus is still on creating a separation between your working life and your emotional life. 4. Treat your time as valuable How many times has a friend or family member called you to ask for help with a pet? How many times have you been tagged in a Facebook post looking for pet advice? Have you received Messenger requests from strangers asking for support? Any time you’ve helped someone in one of these situations, Shawna argues that you’ve been providing telemedicine. The question, then, is whether you charged for that support. It can feel uncomfortable, but offering this kind of help for free can cut into your already limited free time. Here’s how Shawna thinks about it: “You still have to assess that patient, you still have to assess the situation, formulate a plan. That’s worth something. We are worth something.” Another way to think about it: when you respond to these requests, you’re working. Valuing your time and pushing responses to standard in-clinic hours can help you to maintain clearer boundaries. 5. Use the right tools Thus far, we’ve mostly been looking at individual steps for addressing stress and burnout. The issues that most veterinarians are facing can’t really be solved on an individual level, though. For many clinics, the problems are structural, and one key way to fill in the gaps is with technology. Shawna uses Talkatoo for her medical dictation service. It’s a huge time-saver that allows her to move more quickly through the demands of her clinic. For her online pharmacy needs, she uses Vetsource, which keeps revenue in-clinic. Finally, she partners with GuardianVets to cut back phone overload and provide after hours care without needing to be on-call herself. If you’re struggling with burnout, think about the toolset you’re using currently and whether there are processes that you could streamline or offload. Hungry for more? Subscribe to the VetHealth Podcast wherever you like to listen! We’ve got a packed season on the way and we’re excited to share this journey with you.
Battling The Burnout BluesMar 17 2023
Imagine this scenario: Dr. Sarah is a successful veterinarian at a general practice in a small town. She has been working for years and is well-loved by her patients and their owners. But lately she had been feeling burned out from the long hours of her job, especially her overnight shifts. One night Dr. Sarah was called at 1am for a patient that had been having diarrhea for the past two days. The pet was stable, active and still had a good appetite. Dr. Sarah advised a bland diet and scheduled the pet to be seen the next morning. The next day Dr. Sarah was exhausted from lack of sleep and was very fatigued during her appointments. Have you ever felt like Dr. Sarah? By the time she realized how overworked she had become, she was knee deep in stress! A survey of burnout among veterinary practitioners in the United States was published in the January 2021 issue of JAVMA. This study surveyed over 2,200 veterinary practitioners in the US to assess the prevalence and risk factors associated with burnout in the profession. The study found that over 50% of respondents reported experiencing high levels of emotional exhaustion, depersonalization, and reduced personal accomplishment, indicating burnout. Risk factors included working longer hours, lower job satisfaction, and higher levels of debt. The field is both fulfilling and demanding. During long work hours, veterinarians frequently deal with emotional situations, such as euthanizing animals, and delivering bad news to pet owners. These experiences can take a toll on a veterinarian's emotional well-being. Over time, the emotional burden of caring for sick or injured animals can cause veterinarians to experience compassion fatigue. Burnout and compassion fatigue leave behind some noticeable traces. The AVMA wrote that bottled-up emotions, sadness and apathy, and the inability to get pleasure from activities that previously were enjoyable are all symptoms of compassion fatigue. (Source: “Work and compassion fatigue”.) Some veterinarians may feel overwhelmed by the demands of their job, such as managing a busy caseload, managing high call volume, and training new staff. It's important for veterinarians to recognize the signs of burnout and seek help when needed, such as taking time off, seeking counseling, or changing their work environment. How can tech-enabled services help Veterinarians mitigate feelings of burnout? These kinds of services can offer various ways to help veterinarians diminish feelings of burnout. Here are a few examples: Practice management software: Remember the days of the spiral notebook for scheduling appointments? Those hand-written appointment and prescription refill reminder notices? Or those vintage triplicate invoice books for billing out clients? Practice Management Software revolutionized the way practices handled appointments, reminders, and billing, while it also centralized and digitized medical records. “A survey of veterinary practices found that practices that adopted practice management software reported a 25% reduction in time spent on administrative tasks and a 30% increase in client satisfaction" (Source: "Streamlining veterinary practice operations with practice management software" by T. S. Mahan and S. J. Bartlett, Journal of the American Veterinary Medical Association, 2017) Tech-enabled' isn't scary at all! These virtual tools and services have already benefited veterinary practices. Telemedicine: Telemedicine services allow veterinarians to provide remote consultations, which can help reduce the workload associated with in-person appointments. Telemedicine can also make veterinary care more accessible to pet owners, which can help alleviate stress for veterinarians who feel overwhelmed by demand. After-hours triage and virtual front desk services can help veterinarians solve burnout in several ways. Reducing workload is one of the main benefits tech-enabled services provide Veterinarians. After-hours triage services can help reduce the workload on veterinarians by taking calls from pet owners outside of normal business hours. This can free up veterinarians to focus on other tasks, such as patient care, and reduce the likelihood of burnout. Other ways these virtual tools can benefit vets include: Improved work-life balance: By outsourcing after-hours triage and front desk services, veterinarians can spend more time with their families and pursue hobbies or interests outside of work, which can help reduce stress and prevent burnout. "A survey of veterinary practices found that practices offering after-hours triage services reported a 27% reduction in on-call time for veterinarians and a 34% reduction in on-call time for veterinary technicians. Additionally, practices offering after-hours triage reported higher staff morale and reduced staff turnover" (Source: "Effect of after-hours emergency telephone triage on veterinary practitioners' workloads and quality of life" by S. M. Rhind, et al., Journal of the American Veterinary Medical Association, 2018). Enhanced patient care: After-hours triage services can provide pet owners with immediate support when their pet is experiencing a medical emergency. By providing prompt and efficient care, these services can help improve patient outcomes and reduce stress for veterinarians who may feel overwhelmed by a high volume of emergency calls. Improved client communication: Virtual front desk services can help improve client communication by acting as a virtual extension of your veterinary team. This can reduce the number of phone calls and emails that veterinarians receive, freeing up their time and reducing stress. Cost-effective: Outsourcing after-hours triage and virtual front desk services can be cost-effective by deploying remote support staff for a fraction of the cost of employing and training new people. Not only that, remaining in-clinic CSRs and CVTs are freed up for patient care and handling in-person tasks with more focus. By reducing the workload on veterinarians, practices can improve their efficiency and productivity, which can help increase revenue and profitability. Overall, tech-enabled services can offer valuable tools and resources to help veterinarians manage their workload, improve patient care, and prioritize their own well-being. By leveraging these services, veterinarians can mitigate feelings of burnout and maintain a healthy work environment. We have paid close attention to the symptoms of this problem and have the perfect solution for it. GuardianVets’ Virtual Services can meet any level of demand for your practice! Our triage team will sort non-urgent calls appropriately so you can focus on what you love: enhancing pet health and not feeling the stress! Want to know more? Take the next step and reach out to us at email@example.com if you have any questions, or fill out the Get Started form on our website to book your consultation!