Skip to Main Content

If your pet has an upcoming Ophthalmology appointment, please complete the specialty form using one of the options below. 

OPTION 1
Complete Online

Complete and submit the form below.

OPTION 2
Print & Complete

Bring the completed form with you.

Download PDF

OPTION 3
Complete on Arrival

If you prefer, you can complete the form when you get to our hospital.

Ophthalmology Patient Medical Questionnaire

Please answer the following questions to the best of your knowledge. 


Consent for Treatment

I understand that the estimated costs for medical or surgical treatment of this patient and the actual costs may vary. I certify that I am the owner or authorized agent of this animal and do authorize the examination, medical, surgical or other treatments as they are explained to me and are deemed necessary.
By submitting this form, I agree to the above.

From Our Clients

  • "You were all so kind, caring and friendly from the phone call to picking him up after Briggs surgery was a great experience. I would highly recommend y’all to anyone needing your services. Thank you for being so good with Briggs and taking such good care of him! Thanks for making me feel better the whole time I was there and when when I came to pick him up!"
    Tiffany E.

Top

Copyright © 2026. All Rights Reserved.
Part of the PetVet Care Centers Network.

Contact (501) 224-3784