Skip to Main Content

If your pet has an upcoming Ophthalmology appointment, please complete the specialty form using one of the options below. 

OPTION 1
Complete Online

Complete and submit the form below.

OPTION 2
Print & Complete

Bring the completed form with you.

Download PDF

OPTION 3
Complete on Arrival

If you prefer, you can complete the form when you get to our hospital.

Ophthalmology Patient Medical Questionnaire

Please answer the following questions to the best of your knowledge. 


Consent for Treatment

I understand that the estimated costs for medical or surgical treatment of this patient and the actual costs may vary. I certify that I am the owner or authorized agent of this animal and do authorize the examination, medical, surgical or other treatments as they are explained to me and are deemed necessary.
By submitting this form, I agree to the above.

From Our Clients

  • "We were very impressed with everyone on staff. We ended up having to euthanize our sweet dog because of an injury resulting in paralysis. The staff was very sensitive to our situation and offered their condolences several times. The staff explained every option to us including costs. We found them all to be very professional and caring. I would definitely recommend this clinic to anyone needing emergent care for their pet."
    Shelley M.

Top

Copyright © 2024. All Rights Reserved.
Part of the PetVet Care Centers Network. Managed with Tymbrel

Contact (501) 224-3784