Drop Off Form Please enable JavaScript in your browser to complete this form.Date *Client *Phone Number *Email *Patient *As Fear Free Certified Professionals we use peanut butter and other foods to help make your pet at ease. Please indicate if you, or anyone in contact with your pet has a peanut or other food allergy. * *I have, or someone in contact with my pet has a food/peanut allergy.There is no one with a food/peanut allergy in contact with my pet.When did your pet last eat? *will verify at time of drop off in case of changeHas your pet had an adverse reaction to any medications, vaccines, or other procedures? *Is your pet taking any medications (antihistamine, heartworm/flea prevention, antibiotics)? *will verify at time of drop off in case of changeDo you need a refill of any medication? *YesNoWhich medications? *I understand that if needed, you will give complimentary anti-anxiety or other calming medications or supplements to help make my pets stay with us more enjoyable and less frightening. *please let us know at drop off if your pet has been sensitive to any medications in the pastPlease check any additional services requested below:Pedicure Express Anal GlandsEar CleaningEar Hair Removal *pedicures are complimentary with all sedations and anesthetic proceduresI understand that if needed, all pets with live fleas will be administered a product to kill the fleas. (Capstar) This will eliminate the fleas from your pet and protect our hospital from becoming infested and spreading to other pets. If given, a charge will appear on my invoice. *In the unfortunate event that your pet should need CPR or lifesaving measures do you: *Request nothing to be doneRequest CPR and nothing more (Minimal additional cost of $150)Request all possible lifesaving measures to be performed (Minimal additional cost $400)I understand that a late fee will be applied to any pets picked up after closing *I, to the best of my knowledge, have filled out this form and believe it to be accurate and true. *We will print this and have it ready for you to sign at the time of drop off as wellCommentSubmit
