Welcome Form

Client information

  

  

  

  

  

  

I authorize Hawthorne to send me text messages to receive lab results, surgery updates, etc. Standard text message rates may apply.

 

Is Hawthorne your regular veterinary hospital?

YesNo

Please enter your regular vet's information

  

Do you want us to send your pet's medical notes to your regular veterinarian?

YesNo

Where did you hear about our hospital?

FacebookWebsiteOther

 


Pet health history

What type of pet do you have?


 

  

  

Please select all that apply

Are your pets rabies vaccinations current?

Does your pet have any known allergies?


 

What is the reason for your visit?

Please check all the symptoms that apply

Authorization

I hereby authorize the veterinarian (Hawthorne Animal Hospital) to examine, prescribe for, or treat the above described pet. I assume all responsibility of all charges incurred in the care of this animal. Please note that payment is required in full at the time services are rendered. Any charges not paid in full are subject to a 1.5% monthly service fee ($2.00 minimum). Any account turned over to collections will be responsible for any additional fees.