Medical History Form

Name: Care Animal Hospital
Address: 9717 E 93rd St., Tulsa, OK, 74133, United States
Telephone: 918-254-7122
Price range: $

To help us ensure your pet receives the best possible care while here at the clinic please take a moment to answer the following questions that are applicable to your pet’s primary complaint today.

Name *

First

Last

Email *

Phone *

Pet's Name *

Primary Concern *

Duration of the problem? *

Have there been any changes in your pets environment or diet? *

Please Explain. *

Is your pet still eating/drinking/urinating/defecating normally? *

Please Explain. *

Have you noticed any vomiting/diarrhea/coughing/sneezing? *

Please Explain. *

Is your pet taking any medications or supplements? (Heartworm prevention, Antihista-mines, etc…)? *

Please list the medications and dosages. *

Any additional information?

In addition to the $65.00 exam fee, will you give the doctor permission to perform addition-al diagnostics if they feel it is necessary for the best care of your pet? *

If yes, up to what dollar amount do you authorize? *

If no, we will have the doctor call you to discuss further treatment options.

Website

Contact Us

Address

9717 E 93rd St.
Tulsa, OK 74133

Call Us

918-254-7122

Email Us

staff@tulsacarevets.com

Fax Us

918-250-8388

Hours

Mon – Fri: 7:00AM – 6:00PM
Sat: 7:30AM – 12:00PM
Sun: Closed

Send a message.

We'll get back to you as quickly as possible!

Name *

First

Last

Email *

Phone

How can we help you? *

Phone

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