When directed by our staff, complete this form to authorize your pet’s treatments. If you are just arriving to the hospital, remain in your car and sign-in online. If you’ve already signed in, monitor your place in line here.

COVID Intake Form
Which hospital location is treating your pet? *

Client Information

Relationship to Pet *
Do you authorize anyone else to make decisions for your pet? *
Do you have a primary veterinarian with whom you'd like us to share patient records? *

Patient Information

Sex *

Extraordinary Measures Authorization

All admitted patients are required to have a cardiopulmonary arrest code in their record on the day of admission. In the event of cardiac arrest, our health care team must know how you would like us to proceed. Please read the following descriptions carefully and select the arrest code that you would like us to follow in the event of a cardiopulmonary arrest.
CPR Directive *
Please provide our health care team with instructions on how we should proceed if additional medical care is required but we are unable to reach you or your authorized agent (if applicable).
Directive for care when owner cannot be reached *

Click Here to Review Details of Authorization


I approve the treatment plans and cost estimates presented to me. *
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