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Refill Prescription
Home
About Us
Services
Pet Vaccinations
Emergency Vet
Spay & Neuter
Pet Surgery
Rabies Vaccination
Pet Dentistry
Pet Wellness Exam
Dog Food
Blog
Refill Prescription
857-277-7781
Book Appointment
Existing Patient Form
To prepare for your appointment, please complete our new patient form below.
Metrovet Clinic - Existing Patients
"
*
" indicates required fields
Name/Pet Advocate
*
First
Last
Date
*
MM slash DD slash YYYY
Phone
*
Alternate Phone
Email
*
How Did You Learn About Our Clinic?
*
Sign Outside
Google
Facebook
Website
Instagram
Other
Recommendation
If recommended, by whom?
Name of Pet
*
Photo of pet (optional)
Max. file size: 100 MB.
Do you need medication refills at your visit?
Reason for medication refill(s)?
Photo of medication (optional)
Max. file size: 100 MB.
Name of Emergency or Specialty Facilities Your Pet Has Visited (if Applicable)
Name of Insurance (if applicable)
We tailor your vet’s visit to their personality and needs. Please tell us about your pet, their comfort level at past vet visits, and anything else that may help us make their experience positive!
Reason For Your Upcoming Visit
Annual Wellness Exam
A Medical Condition or Emergency
A Medical Recheck, Surgery, or Diagnostic Test
Medication Refill Request
During our annual wellness exam appointments, our veterinarian will examine your pet, answer any questions, and provide recommendations to keep your pet healthy. This is also when most of our patients receive their annual heartworm check and vaccines and stock up on preventative medications such as flea, tick, and heartworm. We recommend bringing a stool sample from your pet to test for parasites during the annual wellness visit. If you have any questions, please reach out to our team. Otherwise, we look forward to seeing you soon!
If your pet is facing a medical condition or emergency, contact our team at (857) 277-7781 to discuss booking an emergency visit. Please also complete any details below about your pet’s condition or current symptoms. We look forward to serving you and your pet soon!
Please share any details below about your pet’s current symptoms or condition. For questions, don't hesitate to contact our team at (857) 277-7781. Otherwise, if your pet is not currently experiencing an emergency medical condition, we’ll reach out to discuss the best days and times for your pet’s recheck, surgery, or tests. We look forward to seeing you soon!
Select Any Symptoms or Problems You Have Noticed About Your Pet:
Behavioral Problems
Bad Breath/Dental Pain
Bleeding or Blood Present in Stool or Urine
Breathing Problems
Coughing
Diarrhea
Difficulty Urinating or Defecating
Eye Pain/Discharge
Gagging
Lack of Appetite
Lethargic
Licking Skin or Paws
Limping
Loss of Balance
Scooting
Scratching
Shaking Ear or Scratching
Sneezing
Parasites Such As Fleas/Ticks/Worms
Thirst or Urination Increased
Vomiting
Weakness
Wound/Laceration
Other
Depending on the symptoms your pet is experiencing, it may be critical that they are seen immediately. If you are concerned about your pet or believe they need emergency care, please call our team at (857) 277-7781.
When did your pet’s symptoms start?
Since your pet’s symptoms started, have they:
Improved
Worsened
Stayed the same
Has your pet experienced any changes in the following (check all that apply)?
Diet
Environment
Medicine
Pet’s Current Medications or Changes to Medications
Is Pet on Preventatives? (Flea, Tick, Heartworm)
Describe Any Changes to Your Pet’s Diet Since Last Visit (Brand of Food and Feeding Schedule)
*I hereby authorize the veterinarian to examine, prescribe for, and/or treat the above described pet. I assume full responsibility for all charges incurred for 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.
*
*I hereby authorize the veterinarian to examine, prescribe for, and/or treat the above described pet. I assume full responsibility for all charges incurred for 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.
Please check yes if you agree to these terms and to the use of electronic signature.
Owner’s Signature
*
Date
*
MM slash DD slash YYYY
Do you consent to receive reminders? If so, please select one or more methods below
Text Message
Email
I do not wish to receive reminders about my pet.
We would love to have your pet on our Instagram and Facebook!
Please choose one of the following:
Yes, I give permission to have my pet’s photo taken and put on Metrovet’s social media.
No, I decline to give permission to have photos of my pet on Metrovet’s social media.
Does your pet have its own Instagram? Let us know, and we will follow their account!
Email
This field is for validation purposes and should be left unchanged.
