I certify that I am the owner of the animal(s) listed above. I am at least eighteen (18) years of age and I assume total financial responsibility for the costs of services rendered by Shaker Veterinary Hospital, PC.

I acknowledge that I am not the owner of the animal(s) listed above. I have been authorized by the owner to act on their behalf. I certify that I am at least eighteen (18) years of age and I assume total financial responsibility for the cost of services rendered by Shaker Veterinary Hospital, PC as well as responsibility for the decisions regarding care and treatment of the animal(s) described herein.

Appointment Checklist

1. Bring in a stool sample if the patient has not had a sample checked within the previous year or has diarrhea.
2. Bring in a urine sample if the animal has bloody urine, is straining to urinate, or is drinking or urinating excessively.
3. If your pet has been vaccinated elsewhere, bring the medical records so we can update our records.
4. If the patient is being brought in for a second opinion, bring previous medical records, X-Rays, and laboratory test results, to provide the doctor with as much information as possible.
5. If your animal is on any medications, bring the name, strength and dose or the medication itself