History

Thank you for your help in our efforts to provide a safe environment for clients, pets, and employees during this COVID-19 outbreak. Please fill out the form below so we can collect an accurate, detailed description of your concerns.

Patient History

* Indicates required field

Name *

First

Last

Pet Name *

Phone Number *

Reason for visit today *

Duration of problem *

Current Diet *

Current Medications *

Eating *

Urination *

Drinking *

Skin *

Vomitting *

Activity *

Bowel movements *

Other concerns? *

Would you like a phone call before any treatment is done? *

NO, perform treatment Dr. Burton deems necessary YES, please call before any treatment is done

Preferred form of payment *

Submit

Thank you for the information! Please call our office once you arrive and a staff member will be out shortly to bring your pet back for their exam. We will call you before any treatment is done if you wish. A full discharge summary will be emailed to you for your records.