Get Drop Off Questionnaire - Clanton-malphus-hodges Vet ...

Completing the DROP OFF QUESTIONNAIRE is an essential step to ensure your pet receives the appropriate care at Clanton-Malphus-Hodges Veterinary Clinic. This guide will walk you through each section of the questionnaire, providing clear instructions for filling it out online.

Follow the steps to complete the form accurately.

1. Click the ‘Get Form’ button to access the questionnaire and open it in your designated editor.
2. Begin by entering your client name in the designated space, followed by the date of filling out the form.
3. Next, provide your pet's name in the relevant field.
4. Input the telephone number where you can be reached today for any necessary communications.
5. Clearly state the reason for today’s visit in the specified area, providing as much detail as possible.
6. Indicate how long your pet has been experiencing the current issue by filling in the appropriate response.
7. Mark whether your pet is taking any medications by selecting YES or NO. If YES, list the medications and their administration frequency.
8. Answer if your pet has any allergies to medications by selecting YES or NO. If YES, specify the allergies.
9. Describe the type of food your pet consumes in the corresponding section.
10. Address each of the health-related questions regarding your pet's condition (e.g., weakness, drinking habits) by selecting YES or NO, and provide additional information as needed.
11. Indicate if your pet is on a monthly flea control product and a heartworm product by selecting YES or NO, stating the product names if applicable.
12. Select one option regarding authorization for diagnostics and treatment, detailing any financial limits you wish to set.
13. Add any additional notes for the veterinarian in the provided space.
14. Sign the document in the client signature field to authorize the information provided.
15. Lastly, specify your requested pick-up time to assist the clinic in coordinating care for your pet.
16. Once completed, save your changes, then download, print, or share the questionnaire as needed.

Complete your DROP OFF QUESTIONNAIRE online today to ensure your pet gets the care they need!