Forms Please print and fill out any forms that may apply to your visit. Thank you. This is for veterinary services ONLY. If you would like to access any forms for J.M. Pet Resort, hover your mouse over “Home” tab and go down to “Forms.” You can access all other forms there. Registration Form Surgery Consent Form Pet Vet Registration Form Are you new to J.M. Pet Vet?* New Client Returning Client Name of owner:*Date:*Address:*City:*Zip:*Email(1):*Email(2):Home phone:*Work phone:Please also provide an ext. if necessary. Cell phone (1)*Cell phone (2)May we contact you via text message?* Yes No If so, please list cell phone provider:*Emergency Contact:*Phone:*Do you have pet insurance?* Yes No If so, please list provider:Pets Name:*Breed:*Sex:* Male Female Spayed/Neutered:* Yes No Pet's Date of Birth:*How did you hear about J.M. Pet Vet?*Are you interested in that J.M. Pet Resort offers?* Nutrition Consult Spa Grooming Obedience Training Private Training Lessons PLAYtrain® Doggie Daycare Luxury Boarding Pet Taxi Medical HistoryReason for visit?*Are your pet's vaccinations current? Yes No When were the last vaccines administered?*Where were vaccines administered?*Is your pet microchipped?* Yes No Is your pet on any flea and tick prevention?* Yes No If so, which kind?Is your pet on any heartworm prevention?* Yes No If so, which kind?Is your pet allergic to any drugs?*Is your pet allergic to any drugs?* Yes No If so, please list drugs:Is your pet currently on any medications?* Yes No If yes, please list medications:What's your pet's current diet and feeding schedule (including treats)?*Are there are any current or past medical conditions of that we should be aware of?* Yes No If yes, please explain:Any other relevent information that you would like to share about your pet?* Yes No If so, please list:I, the undersigned hereby certify I am the owner or appointed agent and authorize treatment of the above animal. I hereby authorize the veterinarian to examine, prescribe for and treat the above described pet. If this animal should injure itself in an escape attempt, soil itself, become ill, be exposed to infectious disease or die while in the clinic, I will hold J.M. Pet Resort free of any responsibility and/or liability in connection with this treatment. I understand that J.M. Pet Resort has the irrevocable and unrestricted right to utilize or publish photographic or video images of my pet for marketing and promotional purposes, without expectation or compensation. All such images remain the sole property of J.M. Pet Resort. 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 treatment. By signing below, you are indicating your agreement of the terms hereof in this registration form.* I agree Name First Last Date Signature Brochure Your browser does not seem to support iframes. Click here to read this PDF.