Paramount Animal Care Forms - Paramount Animal Care

Welcome to Paramount Animal Care. We are committed to providing paramount care for you and your pets. Please fill out and submit both the Patient Registration Form and the Pet Health History Form. These forms can be submitted online or you may print out the forms using the Printable Patient Form button above.

* denotes a required field.

Paramount Animal Care Patient Registration Form

Pet Health History Form

Pet Health History

Name (Last, First) *

Cell Phone *

Name of Pet *

Breed *

Color

Birthday

Vaccination history (Date and type of last vaccine) *

Please check any and all symptoms or concerns you are having with your pet *

If Other (Please Specifiy) *

Pet’s Current Medications/Supplments *

Describe your pet’s diet *

Pet’s Allergies

Payment
I UNDERSTAND THAT FEES ARE TO BE PAID AT THE TIME SERVICES ARE RENDERED
I assume responsibility for charges incurred while receiving care at Paramount Animal Care. I understand that not only will payment be required upon release of pet but that additional deposit may be required for certain surgical procedures.
Preferred Method of Payment *

Authorization of Profession Services
I authorize the veterinarian at Paramount Animal Care to examine, treat, or prescribe for the above described pet. Signature of Owner *

Date *