Canine Drop-Off Registration Form

To ensure your pet gets the best care we can offer, please fill out the form completely. Please Note: All * fields are required.

Owner's Name(Required)








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Section I: Procedure Authorization

Please rest assured that your pet will receive the high quality care and attention they deserve as an important member of your family. If you have any questions or concerns during the day, please feel free to call our hospital.
I hereby authorize performance of the procedures listed above. (If unexpected results are found which require immediate attention, the doctor will call you to discuss treatment options.)


Section II: Parasite Control

For the protection of all our patients, any pet left for treatment will be inspected for external parasites (fleas, ticks, ear mites, etc.). If parasites are found, we will apply the appropriate topical treatment at the single-dose price.

Microchip

Every two seconds a family pet is lost. Many are never reunited with their families because they cannot be identified. Because of these statistics, we suggest microchips whenever a pet is sedated. HomeAgainchips are known nationwide and have a 24 hour hot-line to match chip numbers with owner’s contact information. The cost of microchip implantation is $58.00.
Microchip Implantation

Signature *


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