Name *

First Name

Last Name

Phone *

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Additional Phone Number

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Pet Species *

Canine

Feline

Immunization Information & Consent Form *

I understand the risks associated with failure to vaccinate my pet as well as the potential side effects associated with receiving vaccinations.

Vets to Pets practices Fear Free animal handling. If a pet is fearful, aggressive, or anxious, we may choose to use tools such as muzzles, calm & cozy cat wraps, and premedications to help your pet have a better experience. If an animal is too stressed or anxious to be handled, we will discontinue service and reschedule the appointment so we can develop a fear free protocol for your pet. *

I understand if my pet is experiencing high levels of anxiety, fear, or stress, my appointment may be rescheduled.

We prescribe & require Gabapentin for all feline patients. Gabapentin is a very mild sedative, and an incredibly safe medication! Our feline friends tend to have a much higher anxiety level than canines, so we prescribe Gabapentin as a preventative measure to ensure that they are as comfortable and stress-free as possible. *

I understand Vets To Pets will prescribe Gabapentin to be administered prior to my appointment.

N/A (canine patients only)

Client Code of Conduct *

Vets To Pets Mobile Veterinary Service is a concierge service that prides ourselves on quality medicine with the added convenience of in home veterinary care, allowing us the extra time to focus solely on your pet. Please understand that our prices, in comparison to traditional clinics, reflect this higher level of care. To ensure we are able to offer our services to the community in a timely manner, Vets To Pets will only see patients with an appointment. All of our veterinarians will have their state issued license with them and available to see upon request.

I understand

We offer wellness examinations, comprehensive preventative care, and non emergent medical appointments. Vets To Pets is not able to see an emergency. If a medical issue is discovered during the examination that we are unable to treat (for instance, situations requiring radiographs or surgery), our veterinarian may suggest a follow up appointment with your regular veterinary clinic. *

I understand that Vets to Pets does not provide emergency care, radiology, or surgery at this time.

Vets To Pets appreciates all client feedback. If you have a concern about your recent visit, please contact vetstopetsmanagement@gmail.com. We will not tolerate negative social media posts about our services. It is required that all our staff and doctors be treated with the utmost respect. Any deviation from these standards will result in termination of our doctor/client/patient relationship. *

I understand that if this occurs, the doctor/client/patient relationship will be terminated.

I am the owner or responsible agent for the pet(s) listed above and assume responsibility for all charges incurred in the care of this/these pet(s). I understand there is a 3% surcharge for all credit card card payments. Vets to Pets accepts payment via credit or debit card, e-check payments, or cash. I understand that payment will be collected at the time of service. *

I understand Vets To Pets will collect the payment in full during my appointment.

Our veterinary services utilize ScribbleVet, a dictation software from Kairo Care Inc. By checking this box, you indicate that you are aware that your appointment may be recorded to improve medical record documentation. *

I acknowledge that my appointment may be recorded for improved medical record keeping.

We require verbal authorization prior to any photography or recording of our team. *

I understand that I need to ask for permission prior to photographing or recording any Vets to Pets staff members.

We allow cancellations until 24 hours prior to the scheduled appointment. If you need to cancel an appointment within 24 hours, there is a $100 cancellation fee. *

I acknowledge that if I cancel my appointment within 24 hours of my scheduled appointment time, I will be billed a $100 cancellation fee.