To help prevent the spread of infectious diseases, ALL hospitalized/ boarded animals and grooming clients must be current on all vaccinations. Otay Pet Vets hospital policy requires the DHPP+C/DHLPP+C, Bordetella, and Rabies to be current in order for your pet to receive these services. DUE TO STATE LAW AND INSURANCE REQUIREMENTS, ALL DOGS & CATS MUST BE CURRENT ON A RABIES VACCINATION. Vaccinations can be updated at the time of your appointment if they are not current.

I understand every effort will be made to achieve a successful outcome and to provide for all possible safety in hospital care and handling. I hereby authorize this hospital to receive, prescribe for, treat, or perform surgery upon the pet(s) listed on the reverse side and additional pets I present. Furthermore, I agree to pay fees for services rendered at the time the pet is discharged from the hospital or the service is otherwise terminated. I agree to pay for the reasonable costs of collection in the event that collection efforts become necessary. I understand that a service fee of $25.00 will be assessed for each non-sufficient funds check. There is also a $25.00 service fee for any unpaid accounts that require a certified letter to be sent. All accounts unpaid after 30 days receive a service charge of 1.5% monthly with a minimum monthly charge of $3.00. I understand that veterinary service is not provided during night time hours. Continuous presence of qualified personnel is not provided after business hours. If I neglect to pick up my pet within 14 days of the discharge date and do not notify you within that time period, you may assume that the pet is abandoned and are hereby authorized to dispose of the pet as you deem best and/or necessary.

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When is the best time to call about your pet?
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Animal Medical History

Please complete information for all of your pets Pet 1 Pet 2 Pet 3
Pets Name
Species (Dog, cat, walrus, etc)
Breed
Description (color and markings)
Age or Date of Birth (approximate)
Sex
Altered or Spayed?  Yes No  Yes No  Yes No
Diet (name of pets food)
Daily Meds, Vitamins or Treats
Hours spent outside each day?
Microchip?  Yes No  Yes No  Yes No
Heart worm Medicine (which product)
Flea / Tick protection (which product)
Vaccinations (dates given)
Dogs: Pet 1 Pet 2 Pet 3
DA2PP (Distemper/Parvo)
Bordetella (Kennel Cough)
Corona
Other Vaccines (please specify)
Rabies
Giardia
Lyme
Rattlesnake
Cats:
FVRCP (Infectious Disease)
FELV (Feline Leukemia)
FIP (Feline Infectious Peritonitis)
Rabies
Has had FELV Test?  Yes No  Yes No  Yes No
Has had FIV test?  Yes No  Yes No  Yes No
Has had Fecal Test? (stool exam for worms)  Yes No  Yes No  Yes No
Dentistry (approx date work was done)
Blood Testing

Medical History - Prior Illness / Surgery / Concerns: