West Esplanade Veterinary Clinic 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Pet ID# and Client ID# at the top of the form. This information is essential for identifying your pet's records.
3. Indicate whether your pet ate this morning by selecting 'Yes' or 'No'.
4. Fill in your pet's current diet in the designated field to provide important dietary information.
5. If your pet is on any medications, check 'Yes' and list the medications along with the last dose given. If not, select 'No'.
6. Review and initial next to the statement regarding flea or mite treatment charges if applicable.
7. Enter the approved estimate amount for expected charges and initial to confirm understanding of payment policies.
8. Choose one option for pre-surgical work-up and initial accordingly to indicate your approval or decline.
9. Authorize post-surgical pain medication if necessary by initialing in the provided space.
10. Read and initial the surgical/anesthetic waiver, acknowledging understanding of risks involved.
11. Finally, print your name, your pet's name, sign, date, and provide contact phone numbers where you can be reached.

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