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Pet Owner's Name
Email Address
Pet's Name
Pet's Birth Date (approximate age is OK)
Species
Dog
Cat
Sex
Male
Female
Male, Neutered
Female, Spayed
Unknown
Breed
Color
Is this pet new to your home?
Yes
No
Where did you get the pet?
Breeder
Shelter
Rescue Organization
Found as Stray
Friend
Other
How long have you had this pet?
Any know drug allergies?
Yes
No
If yes, please list below.
Notes
If you have previous medical records for your pet, please bring them with you to your appointment.
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