|E-Mail Address : |
|May we text you updates?|
|Please tell us how you heard of us? (required)|
|Pet's Name (required)|
|Age: Years, Months|
|Are your cats vaccines current?|
|Do you have pets medical records?|
|Medical records at another veterinary Practice?|
|Name of Former Veterinary Practice|
|May we request a transfer of records?|
|May we use any images of your pets we obtain on our social media sites, anonymously? (required)|
|Please list any additional pets here|
I understand, by indicating I agree and submitting this registration, professional fees are to be paid at the time services are rendered. At your request, we will gladly provide a written estimate of cost for recommended procedures.
To prevent the spread of infectious disease and parasites, we require that all patients be current on all appropriate vaccinations. Also, cats with fleas and/or intestinal parasites will be treated with an oral or topical medication upon admission, and the prescription price will be included on your invoice.
I agree to give the doctors and staff members of Just Cats Veterinary Services permission to discuss my cats medical condition with and provide records to insurance companies, boarding facilities or other veterinarians incicultation with my cats well being.
In case of emergency, I authorize Just Cats Veterinary Services to treat my cat as they deem appropriate. I understand that all available resources will be exhausted in an effort to contact me prior to initiating treatment.
|I have read this statement and - (required)|
If you have not already scheduled an appointment please call the clinic and fill out and submit the Patient History Form.