Cardiology Outpatient Check In Form

  • Cardiology Outpatient Check In Form

  • Format: (000) 000-0000.
  • Is your pet's diet grain free?*
  • Is your pet currently taking ANY medications?*
  • Is your pets appetite level normal or abnormal?*
  • Is your pets energy level normal or abnormal?*
  • Has your pet had any respiratory concerns?*
  • Has your pet had any coughing?*
  • Have you ever noted any weakness, fainting, collapsing or seizure like activity?*

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    CPR Consent

    Ultrasounds are a safe, non-invasive procedure. We do not anticipate an emergency during the procedure. In the very unlikely event of an unexpected decline in your pet’s health, we aim to respond in a manner that respects your wishes and addresses both emotional and financial considerations. Emergency CPR/Resuscitation measures may include the following procedures:

    • Establishment of an airway via insertion of an endotracheal tube
    • IV catheterization
    • Administration of IV fluids
    • Injections of medications
    • Chest compressions

    Please be aware that animals successfully resuscitated after cardiac arrest are typically in a critical and unstable condition. The management of these patients necessitates continuous monitoring and technical expertise, with an uncertain outcome.

    It is important that you know the cost of the CPR starts at $300 and the total will vary depending on your pet's needs. The cost of CPR and any further care are in addition to your current estimate. Your pet would require transfer to a local emergency and specialty center. 

    Please select one of the following options:

  • CPR Status*
  • Should be Empty: