Okaw Veterinary Clinic

140 W. Sale
Tuscola, IL 61953

(217)253-3221

www.okawvetclinic.com

Easy Pet Exam Appointment Form

 

 

Please fill out entire form to set up your appointment. If you do not hear from us in 3 business days, please call us at 253-3221 or email okawvetstaff@mchsi.com.

 


Name:
Phone number:
Zip code:
Email address:
Referred by:
Pet's name:
Pet's age:
Dog or Cat?
Breed:
Gender:
Spayed or Neutered:
Treatment your pet is difficut for:
Has your pet needed sedation to be able to do this?
Any biting while you are doing this?
Has your pet scratched you while doing this?
Has your pet wriggled around when you are doing this?
Is your pet frozen still when you do this?
What is the goal behavior you want to see
Do you have any concerns?
What days work best for your appointment?
What time of day works best for you?
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