Patient History Form

  • Lots of love and attention will be given to your furry friend while they're in our care! Please fill this form out completely and accurately and please be able to answer your phone during this appointment. The more attention you pay to this form now, the more time your Vet can dedicate to consulting with you! Thank you!
  • * Indicates required information
  • If you've had recent exposure or clinical signs associated with COVID-19, please be responsible and send someone else to drop-off and pick-up your pet or reschedule for a later date. This is extremely important for the safety of our staff and other clients. We greatly appreciate your honesty and empathy. We agree with your pet, you're the best.
  • MedicationHourMinuteAM/PM 
  • Please only click "Submit" once and do not leave this page! This may take a few seconds. From everyone at PAZ - Thank You!
  • This field is for validation purposes and should be left unchanged.