Dog/Cat Welcome Form

Thank you for giving us the opportunity to care for your pet.  We will be happy to answer any questions you have about your pet’s health.  To insure the best care possible, please take time to fill in this form completely.  Thank You!

Dog/Cat Welcome Form
How did you learn of our hospital? Please check all that apply *

Number of Pets

Pet Health History

Pet One

Please check (√) any symptoms or problems that you have noticed about your pet. *

Pet Two

Please check (√) any symptoms or problems that you have noticed about your pet.

Pet Three

Please check (√) any symptoms or problems that you have noticed about your pet.


Authorization

I hereby authorize the veterinarian to examine, prescribe for, or treat the above described pet(s). I assume responsibility for all charges incurred in the care of this animal(s). I also understand that these charges will be paid at the time of release and that a deposit may be required for surgical treatment. I also authorize the hospital to use photos and/or other likeness of myself and/or my pet(s) for their medical record or other purposes. MUST BE 18 OR OLDER TO AUTHORIZE.
Method of Payment:

What our Clients are Saying

The staff is fantastic. They were very attentive with my newly adopted fur baby, answered all of my questions and let me know the cost of treatments and meds upfront so there were no surprises at checkout. Top notch and highly recommended!

~ Heather I.

I wouldn’t take Cody anywhere else. Dr. DeSimone and your staff are extremely knowledgeable, compassionate and caring of not only my four legged babies but their Mom as well. Thank you for everything.

~ Carol R.

Oh my goodness not sure you could have done anything differently. You all were kind, accommodating, thorough, and excellent listeners. You ALL are FABULOUS!

~ Elizabeth B.

Sumo has severe cardiovascular issues that were discovered by a very thorough DeSimone and through this, led to treatment that saved his life. Beyond excellent care. Cannot recommend highly enough.

~ Ramona C.

The doctors and tech team are so kind and compassionate. They have great bedside manner and have really mastered the idea of relaxing the environment but still being direct and clear. We brought our French lop in for a sick visit after having some respiratory issues. The staff handled both her and us with such compassion and care. They even called a few days later to ensure we weren’t having issues administering her medications and to check in. They will exclusively be our vet going forward!

~ Nicole R.

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Pattersnap