Drop Off Questionnaire for Sick Pet

I am the owner/agent for described animal, authorize, and request an exam for my pet. I understand that sedation and/or pain medication will be provided if deemed reasonable. I understand the veterinarian will contact me after they have examined my pet to discuss recommended diagnostics and treatment, and will have an initial estimate of charges. I understand payment is due when my pet is discharged, however, a deposit may be required after an estimate is prepared and discussed. I accept financial responsibility for charges incurred for this pet.

Client Information

Patient Information

Symptoms your pet is displaying