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Hours 433 3rd St
Lake Oswego, OR 97034
(503) 635-3573

New Patient Form

We know your pet's health is important, and we thank you for trusting us to care for them. To help us provide the best care possible, please take a few moments to fill out this form completely. Thank You!

I authorize Full Circle Veterinary Care to call and obtain any/all previous medical records for my pet(s).

I agree to keep my pet(s) contained or leashed while in common areas of Full Circle Veterinary Care.

I understand that all charges for treatments and services are due in full on the day of service/treatment.

I understand that all appointment cancellations must be made at least 24hours in advance. Canceling less than 24 hours prior to or not showing up for an appointment may result in an appointment cancellation fee.

I understand that no one but myself or the other pet parent (owner) listed (if any) can make medical decisions or authorize treatments for my pet. If I am unable to bring my pet in for any reason and would like to authorize someone else to make medical decisions, I will contact Full Circle Veterinary Care beforehand to approve that individual(s).

I understand that by law, Oregon requires all pets to be vaccinated for Rabies. By acknowledging this statement, I agree to take full responsibility for any legal actions or consequences assigned to me if I choose not to vaccinate my pet for Rabies.

I understand that Full Circle Veterinary Care does not accept returns of any preventive care medications or prescription drugs once they leave the hospital.

I understand that VetSource is the only online pharmaceutical company that directly works with. If I choose to use any other online pharmacy, I understand that the products obtained may not be guaranteed by the manufacturer.(Access to Vetcove Online Pharmacy: Our Online Pharmacy)

Patient

 

Yes

No

Is your pet current on all vaccines?

Has your pet ever had a reaction/side effect from a vaccine? If yes, please list medications.

Has your CAT been tested for FELV/FIV within the last year?

Are there other pets in your household?

Is your pet CURRENTLY receiving medication for flea/tick/heartworm prevention?

Does your pet have access to table scraps/meat bones/raw meat?

Has your pet traveled outside of the Pacific Northwest?

Has your pet ever had a seizure?

Full Circle Veterinary Care