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Preventative Care Drop Off Form

Please complete the following form before your visit!

preventative-care

Preventative Care Drop Off Form

Please read and fill this form out if you are dropping your pet for a routine veterinary visit today. A doctor or other veterinary staff may need to contact you in regards to selected services selected or performed. Please leave the best contact information for today.

Preventative Care Services

A visit by veterinary staff is required for vaccination appointments

Vaccines: Please mark, or confirm, which vaccination(s) you would like updated today

Concerns?

I hereby authorize the veterinarian and Fitchburg Veterinary Hospital to perform the procedure or treatment(s) marked above. I am the legal owner/agent for the animal on this form. I understand full payment is expected at time of discharge.