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Home
About
Services
Resources
Specials
- Fur-iends
Book Appointment

Online Forms

Online Forms

Drop Off Form

Save time during your appointment! Complete your required form online from any device at any time before your visit.

a person holding a dog on a leash

Drop Off Form

Please complete this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit.

Email *

Name *

First

Last

Check-In-Date *

Primary Contact Number *

Secondary Contact Number

Pet's Name *

Primary Complaint *

How long has this been going on? *

Has your pet ever been previously diagnosed with any health conditions? *

Has your pet been experiencing any of the symptoms listed below? *

Not eating
Not drinking
Drinking in excess
Lethargy
Acting painful
Coughing
Sneezing
Scratching
Shaking head
Limping
Scooting
Diarrhea
Vomiting
Weight Loss

Would you like us to update any of your pet's vaccines while they are here if appropriate? *

Yes, update my pet's vaccines if any are past-due.
No, do not update my pet's vaccines at this time.

**In the State of Texas, an up-to-date Rabies vaccination is required. If your pet has never received one before or their vaccine is currently expired, one will be administered while they are here. *

I understand.

Would you like us to refill your pet's heart worm/ flea and tick prevention while your pet is here? *

Yes, please refill these medications.
No, do not refill these medications at this time.
My pet is not on any prevention at this time, but I would like to get him/her started on them.

Anything additional you feel needs to be done: *

Nail Trim
Express anal glands
Ear cleaning/flush
None

Did your pet eat this morning? *

Yes
No

May we sedate your pet if needed? *

Yes
No

May we do blood work if needed? *

Yes
No

May we do x-rays if needed? *

Yes
No

Please list any medications your pet has taken in the last 7 days and the date of their most recent dose:

** I understand that all charges accrued throughout the day will be due at the time of pick up. I understand that if my pet has external parasites it will be treated at my expense. I have read and understand this authorization and consent. *

Yes, I understand.
No, I do not understand.

** NOTICE: Personnel are not on the premises at night and other times when Palo Duro Animal Hospital is not open for business. *

I understand.

Comments

Phone

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We proudly serve the pets of Canyon and the rest of the Panhandle. We look forward to seeing you and your pet! Book an appointment by clicking the button below.

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Questions?

Get in touch! We look forward to hearing from you.

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Location

1901 4th Ave.
Canyon, TX 79015

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Contact Information

Phone: (806) 655-2106
Fax: (806) 656-0080
Email: palodurovet@gmail.com

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Hours

Mon-Fri: 7:30 am – 5:30 pm
Sat: 8:00 am – 2:00 pm
Sun: Closed

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Phone

How can we help you? *

Email

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