We are pleased to welcome you to our practice. Please take a few minutes to fill out this form as completely as you can.

Owner / Caregiver

Pet Information

Referral Information

Please tell us how you learned about our practice. Check any of the following boxes that apply.

If this was a personal recommendation who may we thank?

Social Media

Log Cabin Animal Hospital may choose to use photographs of your pet on our website, Facebook Page or other forms of social media. Would you like to see pictures of your pet on these pages and agree to us using the images?

PAYMENT

We will gladly prepare a written estimate of service fees if you desire. All professional fees are due at the time of services rendered. In case of extensive medical or surgical procedures a deposit will be required and the remainder of the balance is due at discharge.

Statement Of Ownership

By checking below you certify that you are the owner and or agent of the above animal and have the authorization to consent to treatment if and when it is needed.