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For Pet Parents

New patient form

Fill this in here and it goes straight to the clinic, no printing, no scanning, no hunting for a pen. It takes about ten minutes, and you can do it on your phone.

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About you

So we know who to reach, and how you would like to hear from us.

Please add your name.
We need a number to reach you on.
Please check the email address.

About your pet

The basics. Estimates are fine where you are not sure.

Please add your pet’s name.
We work alongside your vet, so we do need this.

How your pet is with people

This is for everyone’s safety, including your pet’s. Being honest here means we can set the room up so they are comfortable.

A sentence is plenty.

Why you’re here

What you have noticed at home matters more than the right terminology.

Tell us what brought you here.

Medical history

Write what you know. Nobody expects exact dates from memory.

Daily life

How your pet actually spends their days shapes the plan we build.

Consent and release

Please read each line and check it to confirm you have understood it.

Please type your full name.
Please add today’s date.

Texas requires a veterinary referral before rehabilitation care begins. That is a separate form your own veterinarian signs — it is on the vet referral page. Anything you are unsure of, leave it and call 303-388-6886; we will go through it together.

Would rather do it on paper? The same form is here as a PDF. You can type straight into it on a computer or phone and email it to info@rehab4pets.com, or print it, write it out and bring it with you.

Download the paper form (PDF)

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Questions

Questions we get asked

Do I have to fill this in before my first visit?

It helps, but it is not required. Completing it beforehand means more of your appointment is spent with your pet rather than on paperwork. If you would rather do it at the clinic, that is completely fine.

Can I type my name instead of signing?

Yes. Typing your full name at the end counts as your signature, which is why the form asks you to confirm that.

What if I cannot answer some of the questions?

Write what you know and leave the rest. Nobody expects exact dates or dosages from memory, the gaps get filled in together at the appointment.

Is this the same as the veterinary referral form?

No. This one is yours. The referral form is a separate form that your own veterinarian completes and signs, because Texas requires a veterinary referral before rehabilitation care begins.

Stuck on anything?

Call the clinic and we will go through it with you.

Call 303-388-6886