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🐾 Pet Drop Off Information

Please complete this form before your pet’s appointment. Your answers help us provide the best care possible.

Client Name:

Phone Number where you can be reached at TODAY:

Pet's Name:

Breed:

When was your pet's last meal?

What did he/she eat?

What medications (if any) has your pet received in the last 24 hours?

Is your pet sensitive or allergic to any medications or food ?

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Yes

What vaccinations, if needed, would you like us to give your pet today?

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Rabies

Distemper-Parvo

Feline upper respiratory

Feline Leukemia

Please describe the problem(s) your pet is having, pertinent history leading up to the current condition, any previous major medical problems, and what you would like us to do below:

Would you like us to:

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Treat your pet after examination?

Call you with the findings of the examination and an estimate of treatment cost prior to our treating your pet?

* Please note that if we have not seen your pet before, we will need to be able to contact you regarding your pet’s examination prior to instigating any treatments.

PROFESSIONAL FEES ARE TO BE PAID AT THE TIME SERVICES ARE PERFORMED

In admitting my pet(s) for diagnostics, treatment, or surgery, I authorize the veterinarians of Cherry Creek Veterinary Hospital, and their support staff, to administer such treatment and/or perform such diagnostic or surgical procedures as deemed necessary.

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