Ophthalmology For Animals Welcomes New Patients

New Patients Paperwork

We are excited to welcome you and your pets as new patients at Ophthalmology For Animals! Please fill our our New Patient Paperwork below.

Appointment Status(*)

Yes, I have an appointment scheduled
No, I need to schedule an appointment

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Pet Owner Information

First Name(*)

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Last Name(*)

Please type your full name.

Spouse/ Partner/ Other Agents

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Street Address(*)

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City(*)

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State & Zip(*)

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Home Phone

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Work Phone

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Cell Phone

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Occupation

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Drivers License

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E-mail(*)

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Primary Veterinarian/ Clinic(*)

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Please Tell Us About Your Pet(s)

Pet Name(*)

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Pet Approximate Birth Date?

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Cat/ Dog/ Other(*)

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Breed(*)

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Color(*)

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Sex(*)

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Spayed/ Neutered(*)

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General Temperament?(*)

Nervous Aggressive Sweet

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Please briefly explain your pet's condition and the reason for your visit.(*)

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Will you be bringing in a second pet during your visit?(*)

No Yes

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Pet Name

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Pet Approximate Birth Date?

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Cat/ Dog/ Other

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Breed

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Color

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Sex

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Spayed/ Neutered

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General Temperament?(*)

Nervous Aggressive Sweet

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Please briefly explain your pet's condition and the reason for your visit.

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Terms & Conditions

We value your bond with your primary veterinarian.  A referral to a specialist indicates your veterinarian’s concern for your pet.  Your veterinarian will be provided with a report of your visit to ensure continuity of care.  During your treatment with us, Ophthalmology for Animals cannot provide general veterinary care for your pet with the exception of emergency care.  The ophthalmologist will inform you of prognosis and anticipated recovery time.  In general, we recommend that you follow up with us for the presenting problem so we can accurately assess your pet’s progress and direct his/her recovery. 

In order to assure an optimum care provider-patient relationship, please comply with the following instructions:  
   
- Arrive promptly for your appointment time.  The time given is reserved just for you. 

- The office requires 24HOUR notice if you cannot keep your appointment or need to reschedule an appointment.  

If you do not give us a 24 hour notice this will be considered a failed appointment, which may result in a $50 failure fee which you must pay before another appointment is scheduled.

I, authorize Ophthalmology for Animals to request my pet’s medical records from my veterinarian and to release a report of ophthalmic findings to my veterinarian. I, the undersigned owner or agent of the owner, understand that payment is expected when services are performed. I will provide payment via cash, check, CareCredit, Visa, MasterCard, Amex, or Discover credit card.

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By checking "I Agree" you are agreeing to all Terms & Conditions detailed above(*)

I agree

You must click "I Agree"

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Covid 19 Ophthalmology for Animals - June 14, 2021

We are pleased to announce that we will begin taking steps to reopen our offices to allow for face to face visits.

The safety of our clients and employees is our highest priority and we will continue to review all available CAL/OSHA and CDC recommendations as we work towards welcoming you back inside. We ask that you please be patient with us as the rules and regulations can change quickly.

Only Vaccinated people with DVM appointments will be allowed into the building at this time, and you may choose whether or not to enter the building.

In order to keep everyone safe all persons will be required to wear a face mask indoors

Our office can only accommodate one client per pet inside of our office as it will be difficult to maintain the proper distancing at all times. You will be asked to answer some questions prior to coming inside.

Allowing inside visits will periodically impact processes and wait times.

Plexiglas shields will be installed at our front desks and hepa filtration systems will be running throughout the building.

We ask that everyone maintains the social distancing practices and utilize the hand sanitizers at the front door and within the hospital.

Once again Masks will be required inside until further notice.

Medication pickups will still be curbside.

When you arrive for your appointment, you may choose to check in via phone or text.

Please do not enter the building without an escort at any time.

Thank you for your continued patience! We look forward to seeing you soon.