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PATIENT PORTAL

MEDICAL EMERGENCY

New Client Additional Pet Intake Form

Select an option

Female

Male

Female Spayed

Male Neutered

What does your pet eat, how much, and how often?

Has your pet had any coughing, sneezing, vomiting, diarrhea, limping, scratching, lump, vaccine reactions or need for calming medication

Coughing

Sneezing

Vomiting

Diarrhea

Limping

Scratching

New Lumps or Bumps

History of vaccine reactions

Need for calming medication

Please Describe

If you don't have a confirmed appointment, what is your availability for scheduling and how soon do you need to be seen?

I understand that Doorbell Vet is not an emergency clinic and available by appointment only

I understand that masks must be worn at the appointment

I give permission to use photo/case information in advertising/blog

I understand payment is expected at the time of service and includes credit card or cash only

I understand a cancellation or no-show less than 24 hours notice before appointment will result in a cancellation fee

Thanks for submitting! We will get back to you within 1 business day

To register additional pets click here

Areas we service:

Disclaimer

The information on this website is only for information purposes and does not replace the advice of your veterinarian. All pets are individuals and without examining your pet it is impossible to give you accurate medical advice. Always check with your veterinarian before using any information you read on this site. The advice and comments found on this site are not a substitute for professional medical diagnosis, treatment or advice. Dr. Dori Marion and Doorbell Vet are not responsible for any damage, illness, death or harm that occurs from information found on this site or links from this site to other resources

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