• HILLSIDE VETERINARY HOSPITAL

  • 191 Augustine Avenue Charles Town, WV 25414 (304) 728-2203

  • Drop Off Consent Form

    Drop Off's will be scheduled with an "arrival time", this is not an appointment, and your pet will be admitted to the hospital for the day. Our doctors look at drop offs in between scheduled appointments, with emergencies taking precedence. Our staff will be in touch once your pet has been examined. Please plan accordingly. In order for us to best understand why your pet is being dropped off, please fill out this form in its entirety, prior to your pet's visit. *Please note - we cannot guarantee which doctor will be seeing your pet while here, as we examine pets in the order in which they are dropped off*
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  • Please check any symptoms your pet is experiencing:



  • Please indicate if/which vaccinations/tests, or services, you would like us to perform today: Please Note: WV state law requires a current Rabies vaccination on all pets. If your pet is not current, we will legally have to vaccinate for Rabies while here today.


  • AUTHORIZATION: I verify I am the owner (or Authorized agent) of the above named pet and authorize the above procedure to be performed. I agree to be responsible for any charges incurred while my pet is in the care of this facility and understand payment is due at the time my pet is released from the hospital. I understand no staff will be attending to my pet if it stays overnight (pets needing special care may be referred to a 24 hour hospital).

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