Drop-Off Treatment Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet’s before your visit.

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Drop-Off Treatment Form

Name *

First

Last

Email *

Date

Pet's Name *

Your pet will be seen by the FIRST available veterinarian for their current condition, unless you request a specific doctor, if available:

Since you will not be present during the exam, please provide the doctor with a specific explanation of their current condition. By providing as much information as possible, the doctor will be better equipped to diagnose and treat the problem.

Duration of problem? *

Last time your pet ate? *

Is your pet currently on any medication or receiving any treatment of any kind? *

If the doctor were unable to reach you today, what further treatment, if any, would you authorize?

Exam
Sedation/Anesthesia
X-rays
Blood/Urine Tests
Whatever Necessary
Other

Call me if my total will be over:

$100
$150
$200
Other

Select preferred payment method: *

Cash
Check
Credit Card
CareCredit

Please leave main phone number where you may be reached today: *

Please list any additional phone numbers where you may be reached today:

Signature *

Clear Signature

Ready For A Visit?

We proudly serve the pets of Camden county. We look forward to seeing you and your pet! Request an appointment by clicking the button below.

Appointment

Have Any Questions?

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

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Location

400 E King Ave
Kingsland, GA 31548

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Contact Information

P: 912-270-3706
F: 888-963-2010
E: betzvetservices@gmail.com

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Hours

Mon-Fri: 8:00 AM – 5:00 PM
Sat-Sun: Closed

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Last

Email *

Phone

How can we help you? *

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