Viewmont Animal Hospital

Hospital Drop Off Form

Please answer YES or NO to the following:

Is your pet on heartworm preventative?
Any travel or boarding recently?
Does your pet go out unsupervised?
Any vomiting or diarrhea?
Eating and drinking normal?
Any coughing?
B.M./urination normal?
If needed, do you authorize bathing, lab test, blood work and/or x-rays?
If sedation is needed, do you authorize needed medication?
Did your pet eat this morning?
Does any other treatment need to be performed while your pet is here?
Please call me with an estimate if my pets’ treatment will exceed $

All vaccinations for your pet must be current while he or she is in our hospital. If vaccines are past due, they will be given at the doctor’s discretion. If your pet is found to have fleas and/or ticks, they will be treated at your expense.