Thank you for dropping off your pet with us today! The following information will be used to help our veterinary team accurately complete your pet’s medical history for today’s visit.Owners Name*Home Phone #Cell Phone #Work Phone #Email* Patient InformationPatient Name*Sex*Age*Reason for Visit*When did you first notice symptoms?*When did you pet last eat or drink?*Has your pet ever had any adverse reaction to any medication?*Is your pet currently taking any medication?*By signing below, you give Happy Pets Animal Hospital your permission to proceed with any diagnostic testing and/or procedures, including sedation, recommended by the Veterinarian. All payments Are Due Upon Service Rendered You Will Be Notified When Your Pet is Ready for Pick UpMax $$ Limit:*(you will be called if the estimated bill exceeds this amount)Phone number you can be reached today*Date* Date Format: MM slash DD slash YYYY Owner / Guardian Signature*EmailThis field is for validation purposes and should be left unchanged.