Cat Clinic Sign Up

Phone Number *

Address *

Address

City

State/Province

Zip/Postal

Preferred Clinic Date

Name *

Email Address *

Cat's Color *

Cat's Coat Length

Short Hair

Medium Hair

Long Hair

Cat's Name *

Cat's Gender *

Male

Female

Cat's Age *

Do you have any concerns about the health of your cat? If so, please make us aware.

Authorization Agreement *

I hereby authorize Dr. Dowty to examine, prescribe for, or treat the pet described above. I assume responsibility for all charges incurred. You are to use all reasonable precautions against injury, escape, or death of my pet, but you will not be held liable or responsible in any manner and it is thoroughly understood that I assume all risks.

By signing or typing your full name in the signature field below you agree to and authorize the above agreements. *

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Check the fee services that you would like for your cat:

Pre and Post Surgery Instructions Agreement *

I will bring my cat indoors the night before surgery, provide a litter box and remove all food before midnight. I will have water available throughout the night. I understand that after anesthesia, my cat won’t be able to regulate his/her body temperature. I will provide a place in my home, with a comfortable temperature and a litter box for at least 3 nights.

Check the complimentary services that you would like for your cat:

Nail Trim - Indoor Cats Only

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