Call: 802-888-7776

Client Form

For all new and returning patients coming in for their yearly health exam.

Client Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit. If this is an emergency, or if your pet needs urgent care, please call us at 802-888-7776 for a faster response.

Updates on COVID-19 – Hospital Policies For All Appointments
*This form is required for all appointments with a doctor. Please fill this form out at your earliest convenience and at least 24 hours before your appointment.

Client Information

If you do not have one please put NA
If you do not have one please put NA
This is where your invoice will be sent after your visit.
Only if applicable
Only if applicable
Only if applicable
Please select all that apply
Please select all that apply

Patient Information

This would be added to their account and potentially used on social media.

Patient Medical Background

If your pet is having diarrhea please bring a fresh fecal sample (no older than 24hrs and needs to be refrigerated if you are not coming right in with it).

If your pet is having urine issues please bring a fresh urine sample (no older than 24hrs old and needs to be refrigerated if you are not coming right in with it).

If your pet is has been vomiting please collect a sample of vomitus for review by the doctor.

Have the symptoms worsened recently? Is your pet uncomfortable? Is there oozing, itching, and/or a smell?
Is your pet in noticeable discomfort? How frequently is your pet urinating inappropriately? Does the urine appear to be discolored or have an odor?
Are they hard or soft? Approximately how big are they?

Additional Pet Health Questions

Please put NA if the answer is no.