Patient history form | Doorbell Vet

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History Form for Current Patients
If you have trouble completing this form please call the office at (585) 441-0200 and one of our client service representatives will get back to you to assist during business hours.

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

What is your availability for scheduling?

If your pet has seen seen by another clinic since your last visit, please list where below

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 or debit card only

Please feel free to upload a photo of your pet or a problem area. Also if your pet was seen by another veterinarian please upload any records below or have them We need your pets recent vet records! Please upload below or have them emailed to info@doorbellvet.com

Upload File

Upload supported file (Max 15MB)

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

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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History Form for Current Patients If you have trouble completing this form please call the office at (585) 441-0200 and one of our client service representatives will get back to you to assist during business hours.

History Form for Current Patients
If you have trouble completing this form please call the office at (585) 441-0200 and one of our client service representatives will get back to you to assist during business hours.