Initial Consult Form

  • Initial Consultation Form

    (Form required for each pet)
  • Species:*
  • What type(s) of diet is your pet currently on? (Check all that apply)*
  • Has your pet ever had a reaction to any food proteins that you are aware of?*
  • Is your pet current on vaccinations?*
  • Which vaccines has your pet had? (please check all that apply)*
  • Is your pet current on heartworm prevention?*
  • Is your pet current on flea and/or tick prevention?*
  • Is your pet on any prescription medications?*
  • Is your pet on any OTC medications/supplements?*
  • Please check all applicable (current and prior) health issues:*

  • Please read and sign/agree in order to schedule IC appointment:

     

    1. I understand that IVS requires ALL prior health records (as far back as possible, with lab results included) to be submitted before we can schedule the appointment.

     

    2. I understand that a deposit of $150.00 (the price of the initial consult/exam fee) will be required to schedule, and the deposit will only be refunded if a minimum of 48 hours' notice is given to cancel and/or re-schedule the set appointment.

     

    3. I understand that IVS is a part-time, appointment-only practice. I also understand because of this, that IVS will respond to all inquiries/requests as soon as possible, but that it is possible that it sometimes may take 24-72 hours for a response. 

     

    4. I understand that IVS is not a full-service practice and is not capable of seeing urgent, emergent, or surgical cases.

     

    5. I understand that there may be times IVS will have to refer my pet to a regular full-service veterinarian due to scheduling, equipment, and/or availability constraints.

     

     

     

  • Should be Empty: