• Drop Off Consent Form, Fillable

  • Hillside Veterinary Hospital

    191 Augustine Avenue Suite 100, Charles Town, WV 25414  // (304) 728-2203

    www.hillsideveterinaryhosptial.com

  • 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*
  • Client Information

  • Pet Information



  • Please indicate which vaccinations, tests, and/or services you would like us to perform today:

    Note: WV state law requires a current Rabies vaccination on all pets. If your pet is not current, we are legally obligated 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(s) to be performed. I agree to be responsible for any charges incurred while my pet is in the care of Hillside Veterinary Hospital 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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