COMMUNITY your pets wellness/sick appointment

Your pets wellness/sick appointment [one per pet]
TO BE COMPLETED ONLY IF AN APPOINTMENT HAS BEEN MADE

To make an appointment, please call 469-620-2828
Name

First NameLast Name
If your pet is fearful, reactive, or has a history of aggression, please inform us in advance. We take these cases very seriously and want to ensure the safety and comfort of both your pet and our team. Not disclosing this information prior to your appointment, could lead to a cancellation and losing your deposit
To the best of my knowledge, my pet:
WHEN IS YOUR SCHEDULED APPOINTMENT?
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Species
Your Pets Name
How old is your pet?
[Leave blank and we will estimate]
Gender
What services are you wanting done today?
Can you drop your pet off? Drop-off appointments allow us to provide thorough care without rushing. Same-day drop-off is available at no charge for sick or injured pets. Drop-off: 8–9am • Pickup: 4:30pm (unless otherwise arranged).
What vaccinations are needed?
What vaccinations are needed?
What add-on services are you needing?

Other
FECAL FLOTATION $18 VERY IMPORTANT parasites can make your pet not only uncomfortable, but it can lead to more serious conditions - even death. Some parasites can be transmitted to humans. Because parasites are very common, a fecal flotation should be done every 6 months
I would like to have a fecal floatation completed - please bring a fresh (same day) sample
If my pet is positive for parasites, please send home 2 rounds of dewormer
HEARTWORM TEST (canine Only) $35 VERY IMPORTANT Heartworm disease is a serious disease that results in severe lung disease, heart failure, other organ damage, and death. A heartworm test is required for any heartworm prevention and is recommended every year
I approve a heartworm test
Send me home with Heartworm/Flea/Tick prevention (Heartworm test required)
Triple Test FIV/FeLV/Heartworms (feline only) $35 VERY IMPORTANT Screens cats for feline immunodeficiency virus (FIV) antibody, feline leukemia virus (FeLV) antigen, and feline heartworm (FHW) antigen
I approve a triple test
Send me home with prevention
Would you like bloodwork done today? Bloodwork helps assess overall health, detect early disease, and monitor changes over time. A baseline in young pets and annual testing in adults and seniors are strongly recommended.
Would you like to add 10 days of Proviable ($18)? This veterinarian-recommended probiotic supports healthy digestion, stool quality, and gut balance—especially during stress, diet changes, or antibiotics.
Do you have any concerns about your pet? If your pet is sick or injured, please tell us what clinical signs your pet is experiencing, and when they started. Please be detailed:
Do you have any medical records on your pet
UPLOAD MEDICAL FILES HERE:

Upload medical records, vaccination history, radiographs, lab work
Cancelof
What questions do you have about your visit?
I agree to let CHEW take pictures of my pets and use them on social media
PAY IT FORWARD! Would you consider making a small donation today? *This will be added to your deposit below
100% of this donation will go to our Compassion Fund - a fund set aside to help families with diagnostics and/or life saving surgeries

Amount due

USDDescription

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Appointment Deposit ($40)
Total
Should be Empty:

Your pets wellness/sick appointment [one per pet]

TO BE COMPLETED ONLY IF AN APPOINTMENT HAS BEEN MADE

Amount due