Follow-Up Visit Information Name(Required) First Last Address(Required) Street Address City State / Province / Region ZIP / Postal Code Email(Required) Enter Email Confirm Email Pet's Name(Required)Please describe your reason for today's visit.(Required)Do you have any other concerns?(Required) No Yes Please describe your concerns for us.(Required)Are you currently using any medications for your pet?(Required) No Yes Please list all medications.(Required)The emergency exam fee is $90.00. All diagnostics, medications, and treatments are additional to the exam fee. An estimate for additional services and medications will be provided and you will have the opportunity to approve or decline and recommendations. Payment is due in full at the time of services rendered. We do not offer any form of billing. We accept all major credit cards, Cherry payment plan, Care Credit, ApplePay and cash. I understand that all veterinary services rendered, including exams, diagnostics, treatments, and procedures, are non-refundable once performed. I also acknowledge that all medications dispensed or administered are non-refundable. By signing below, I accept full financial responsibility for all approved services and products.Signature
