Progress Exam Form

Please enable JavaScript in your browser to complete this form.
Name
Who should we contact to make medical decisions today?
Does your pet enjoy visiting the veterinary clinic?
How has your pet been since the previous appointment for this concern?
Are there any concerns for the following: (check all that apply)
Has your pet ever had any adverse reaction to any medications, vaccination, or other procedure?
Is your pet on any medications?
Do you need any of the following for Flea/Tick/HW/Internal parasite prevention
Once your pet’s exam is completed, we will review the exam findings and recommendations. I understand that financial responsibilities for services rendered are due at the time of discharge.
Many of our patients love peanut butter as a snack while visiting our office, but if you or your pet have an allergy to peanut butter, please let us know. Can your pet have peanut butter?
Drop off appointments: A drop off appointment is available if you are unable to wait at the practice for the duration of your pet’s visit. Please note that there is an additional charge for this service as your pet will be cared for and housed in a kennel until they are able to be picked up. If you need to leave your pet for their appointment, please inform the team member who greets you when you first arrive.
Social Media/Photo Permission: Do we have your permission to post photos of your pet online?
I certify that I am 18 years of age or older and responsible for the financial and medical decisions for the above-mentioned pet.
Signature

Ready for a visit?

We proudly serve the pets of Calhan, Peyton, Falcon, Simla, Ramah, Elbert, and surrounding areas. We look forward to seeing you and your pet. Request an appointment for your pet by clicking the button below!

Call to schedule