Please check out the convenient hospital forms below. These will come in handy depending on which service(s) your pet needs. Just fill them in, sign, and submit. 

Welcome Form

Welcome Form

Thank you for giving us the opportunity to care for your pet. We'll be happy to answer any questions about your pet's health. To ensure the best care possible, please take the time to fill in this form completely. Thank you!
  • Registration

  • I AUTHORIZE FAMILY PET HOSPITAL TO SEND ME TEXT MESSAGE REMINDERS & ALERTS (TEXT MESSAGE CHARGES FROM CELL PHONE PROVIDER MAY APPLY).
  • By providing your email address you agree to receive periodic newsletters and reminders.
  • Pet Health History

  • (Date and type of last vaccinations).
  • Authorization

    I hereby authorize the veterinarian to examine, prescribe for, or treat the above described pet. I assume responsibility for all charges incurred in the care of this animal. I also understand that these charges will be paid at the time of release and that a deposit may be required for surgical treatment.
  • This field is for validation purposes and should be left unchanged.
Boarding Requirements and Release Form
ELECTIVE Surgical Release Form

Elective SURGICAL RELEASE FORM

    Thank you for electing to have your pet’s surgical, dental or other stated procedure(s) performed with Family Pet Hospital. To make the procedure as safe as possible, it is necessary for your pet to have the pre anesthetic blood profile to ensure your pet is healthy enough to withstand the performing the described procedure(s). These blood tests, performed here in the clinic in approximately 20 minutes, are used to evaluate kidney/liver function. These tissues play a vital role in ridding the body of the drugs used to anesthetize your pet for surgery and healing after surgery. ******* Required for pets over 7 years of age*******
  • This screens for heart rate and rhythm abnormalities which could affect anesthesia.
  • Oral meds to go home - $16.50-30
  • I understand that an additional pain injection will be administered if deemed necessary by the attending veterinarian for the stated procedures above at an additional cost of $35.99.

    Your pet(s) must be free of fleas and ticks. Otherwise they will be treated at an additional charge to you. All pets must be current on their annual vaccinations, including Rabies, Bordetella (within 6 months) and distemper/parvovirus.
  • I the undersigned do herby certify that I am the owner (duly authorized agent for the owner) of the animal described above, that I do herby authorize Dr. Jim Burchett and/or his associates and authorized agents to perform said surgical and/ or anesthetic procedure described on my pet and to perform any other procedure or medical treatment deemed necessary by the veterinarian to preserve the life of my pet and will be responsible for the costs of such. I understand that preventative measures will be taken to prevent any unforeseen complications, however by signing this release form I understand the risks involved with anesthesia and surgical procedures on my pet and do herby release the said doctor/agents and authorized servants from any liability arising from said surgery and/or anesthesia on my pet.
  • ALL SERVICES MUST BE PAID IN FULL BEFORE PET IS RELEASED
  • This field is for validation purposes and should be left unchanged.