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!
New Client Form
Media Release Form
Financial Policy Form
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 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?
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
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.
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
Distemper/Parvo
Type of Vaccine
Date of Last Vaccine
Rabies
Bordatella
Leptospirosis
K9 Influenza
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? (*)
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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At Tampa Bay K9 Rehabilitation Center , we provide the highest quality veterinary care to all our patients. Schedule your appointment today.
One fine body…