New Patient Information

Which number is best to reach you?
Can you receive text messages?
How would you prefer to be contacted?
Add a Co-Owner?
Sex
Neutered/Spayed?

Please bring and give any medical records/vaccine records to the receptionists to make copies.

Add a second pet?
I hereby authorize the veterinarian to examine, prescribe for, or treat the pet described above. I assume responsibility for all charges incurred in the care of this animal. I also understand that those charges will be paid in full at the time of release and that a deposit may be required for surgical treatment. Unpaid balances are subject to collection costs including late payment fees, court costs and attorney’s fees.
Four Paws at Fulshear does not work directly with outside pharmacies. Written prescriptions are available upon request that can be mailed directly to an outside pharmacy. Please initial that you read and understand the previous stated policy.
Any small pet that is without a leash or not in a carrier will be provided with a cardboard carrier at the owners expense of $15.00. Please initial that you read and understand the previous stated policy.
Your pet will be checked for fleas during his/her exam. If fleas are found, a Capstar will be administered to your pet at your expense. Capstar is a fast-acting flea treatment for use in dogs and cats that starts killing fleas in only 30 minutes. Please initial that you read and understand the previous stated policy.
If there is a no show / no call appointment, we will require a deposit for future visits. Please initial that you read and understand the previous stated policy.
Please initial.
Do we have your permission to share your pet’s image and story on our social media, website, and other forms of related media? Your name and personal information will never be shared.
I authorize my emergency contact (other than myself or co-owner) to pursue treatment if I am unavailable. Your emergency contact must be an adult over the age of 18.
Sign above