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Home
Our Hospital
Our Team
Hospital Tour
Clinic Information
Careers
Services
Surgery
Wellness Exams
Vaccinations
Dental Care
Spay & Neuter
In-House Laboratory
Boarding
Day Care
Grooming
Hospice & Euthanasia
Internal Medicine
Microchipping
Nutrition
Pain Management
Pet Emergency
Pharmacy
Radiology
TPLO Surgery (Tibial Plateau Leveling Osteotomy)
Pet Owners
New Clients
What to Expect
Forms
Payment Options
Veterinary Resources
Online Pharmacy
Contact Us
Make an Appointment
(913) 851-3700
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*
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*
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Other Authorized Person you would like to add to your chart:
Co-Owner First Name
Co-Owner Last Name
Co-Owner Phone
Please answer the following questions:
Pet's Name
*
Species
*
Dog
Cat
Breed
*
Longhair/Shorthair for non-purebred cats
Color
*
Birthday (or Age)
*
Spayed or Neutered?
*
Yes
No
Would you like to add a second pet?
*
Yes
No
Second Pet Information
Pet's Name
*
Species
*
Dog
Cat
Breed
*
Longhair/Shorthair for non-purebred cats
Color
*
Birthday (or Age)
*
Spayed or Neutered?
*
Yes
No
Additional Information
How did you hear about us?
*
May we release your records to any third party?
Yes
No, I wish to be contacted first
NOTE: A third party may be a groomer, doggy daycare facility, other animal hospitals/referral centers, etc
Photo Consent
*
Yes
No
We love to take photos of our patients for educational purposes, marketing, social media, our website and medical charting reasons. No personal information will be used without your permission. Do you consent to allowing us to take and/or use photos of your pet for the above described purposes?
Are you a Senior Citizen (65 or older)?
*
Yes
No
Are you active or retired military?
*
Yes
No
Who was your previous veterinary clinic?
Previous Medical Records?
Accepted file types: jpg, gif, png, pdf, Max. file size: 50 MB.
In order to facilitate your appointment in an efficient manner, please upload any medical records you may have your pets. If you are unable to upload your pet’s medical records, please bring them with you to your appointment or contact your previous veterinary clinic and have your pet’s records either emailed to
[email protected]
or faxed to 913-851-3716.
Authorization For Treatment
*
I agree
I hereby authorize the veterinarian(s) of Deer Creek Animal Hospital to examine, prescribe, treat and perform procedures for my pets as medically deemed necessary and authorized by me. I understand that I am responsible for all costs incurred and that payment is due at time of services rendered. I understand that Deer Creek Animal Hospital does NOT offer payment plans of any kind and that I may be asked to pay a deposit prior to performing certain treatments or procedures.
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This field is for validation purposes and should be left unchanged.
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