Online Forms

Online Forms

At Tampa Bay K9 Rehabilitation Center, we offer patient forms online so you can complete them in the convenience of your own home or office.

Please print, fill out and sign all three documents and bring them with you to your appointment. Thank you!



For your convenience, we have made the forms fillable online too. ​​​​​​​The forms below can be filled out and submitted on this page without having to download it.

Pet Guardian Information

Pet guardians, is this your dog’s first time here? If so, you’re in the right place. Please fill out the form below to register your dog as a new patient here. If you have more than one dog to register, fill out this form for each dog.

STEP 1

Are you a current or existing client?

First Name (*)

Last Name (*)

Email

Dog's Name

Age

Breed

Color/Markings

Gender

Spayed or Neutered

Name of Referring Veterinarian

Reason for Visit

Date of Inquiry

How did the injury occur?

Has this injury occurred before?

If so, how many times has this injury occurred?

List any previous or current medical issues your dog has experienced.

STEP 2

List any previous or current medical issues your dog has experienced.

List all current medications your dog is taking. (Include heartworm prevention and flea control.)

List any supplements your dog is taking.

Type of food your dog eats?

How much food is eaten in a day?

How often is your dog fed? (*)

Does your dog use a raised bowl? (*)

Do you give your dog table scraps? (*)

Do you give your dog treats? (*)

STEP 3

Describe your dog's living conditions.

Does your dog have to use stairs?

Is your dog allowed on the furniture?

Where does your dog sleep?

What type of flooring is in your home?

List any other pets living in your home.

Is your yard fenced?

Does your dog use a doggies door?

How many days (if any) is your dog crated each week? (*)

How many hours (if any) is your dog crated each day? (*)

What motivates your dog most?

If other, please explain:

STEP 4

What are your expectations of rehab?

Work-up Performed by Referring or Previous Veterinarian

Note: Please bring all history (medical records, Xrays, myelogram, bloodwork results) with you to your rehabilitation consultation appointment for the doctor to review.

If x-rays were taken, what was the date?

Bloodwork

Neuro/Musculature Exam

Myelogram

New/Referred Client Information Form

Pet guardians, is this your first time here? Or were you referred to us by another clinic? If so, you’re in the right place. Please fill out the form below to register as a new or referred client.

STEP 1

Are you a current or existing client?

First Name (*)

Last Name (*)

Email

Phone

Driver's License

Address

Apt/Room

City

State

Zip Code

Employer

Work Phone

Extension

Spouse/Significant Other First Name

Spouse/Significant Other Last Name

Pet Insurance Company (if any)

How did you learn about us?

If other, please explain

STEP 2

Pet Information

Dog's Name

Age

Breed

Color/Markings

Gender

Spayed or Neutered

Immunization Records

Distemper/Parvo

Type of Vaccine

Date of Last Vaccine

Rabies

Type of Vaccine

Date of Last Vaccine

Bordatella

Type of Vaccine

Date of Last Vaccine

Leptospirosis

Date of Last Vaccine

K9 Influenza​​​​​​​

Date of Last Vaccine

STEP 3

Reason your pet is here? (Select all that is applicable.)

Add more info if asked above

How long has your pet had this problem? (*)

What are your expectations? (*)

STEP 4

Payment Information

Please select the payment method you intend to use.

IMPORTANT: By clicking submit below, you are verifying and agreeing to the following statements:

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