Tru Vet Specialty - Recheck Form

1
Owner Information* This field is required.
First Name
Last Name
Phone Number
Email
2
Pet Information* This field is required.
Pet's name
Please Select
Please Select
Canine
Feline
Species
3
Referral Veterinarian
4
Current Medications
5
Has your pet received any medications today?
YESNO
6
Current diet
7
Has your pet been fed today?
YESNO
8
Reason for Today's Visit* This field is required.
9
I understand that TruVet Specialty and Emergency Hospital uses a medical AI scribe that records audio for more complete medical record documentation, and I consent to being recording in accordance with California law.* This field is required.
I consent to the use of AI and to the recording of my appointment for medical documentation.
I do not consent to recording my appointment. I understand that my veterinarian will take manual notes instead.
10
Client Name
First Name
Last Name
11
Signature
Clear
12
Date
Date
Year
Month
Day
Should be Empty: