Drop-Off Form

Drop-Off Form
Location*
Owner's Name*
Pet's Name*
Date of Appointment*

MonthDayYear
Date
Reason for Drop-Off:*

Wellness ExamVaccinationsGroomSick ExamProcedureBathOther
Additional Services:

Nail TrimTop DogDremelBrush TeethMicrochipTLCEAGOther
Minimum Vaccine and Parasite Tests Necessary for Hospital Admission: Rabies, Bordetella, Influenza, Fecal

(Additional vaccinations may be recommended and can be discussed with a staff member)
Do you need Flea/Tick/Heartworm or other medications when your pet is picked up from our hospital?
Parasite Policy

If any fleas, ticks, or other parasites are observed while my pet is in our hospital, I understand that my animal will be treated for these parasites at my expense.
Drop-Off Illness Policy

In the event of a life or death emergency and your pet becomes ill or a medical condition arises, our Doctors and Technicians will always make every attempt to save your pet's life. We will always make every effort to get in contact with you immediately. In the event that your pet develops a non-life threatening illness, but we would recommend a Doctor exam and treatment, please indicate what you would like for us to do while your pet is here in the Hospital.
Please select one*

Please perform whatever services the Doctor deems necessary for the best care of my pet(s) until someone can be reached.I DO NOT authorize treatment of my pet(s) until someone can be reached.
Owner Signature*

Clear
Emergency Phone#*
Emergency Phone#
Should be Empty:

Parasite Policy