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Dental Intake Form

Thank you for giving Gateway Veterinary Services the opportunity to care for your pet(s). During this time, we are asking all clients to fill this out prior to their pet’s appointment.

Please note: In order to schedule an appointment, please call our team or click here. Please schedule your appointment prior to completing the form below.

New to Gateway?
Use this link to find us. https://goo.gl/maps/hFnzntfBojAAyP658

Your pet's surgery day is coming up! Please take a moment to complete these pre-arrival questions to help speed up our surgical intake process. The video below includes some important information for you to be aware of prior to your arrival. Please remember to fast your pet (does not include rabbits or small pocket pets) after 8pm the night before surgery. Water is allowed. Make sure your pet has time to use the litter or is taken for a walk prior to your arrival.

 

Please note that a technician will be calling you tomorrow to review your responses and go over a few questions that we will need to review prior to the day of surgery.

Pet's Name(Required)
Last Name(Required)
MM slash DD slash YYYY
Any issues with head shaking or ear scratching?(Required)
Has there been any vomiting/diarrhea?(Required)
Normal urination/defecation?(Required)
Eating/drinking normally?(Required)
Do you need any dewormer sent home?(Required)
If your pet is due for vaccines would you like us to update them at this time?(Required)
Would you like your pet's nails trimmed?(Required)
If they are not microchipped would you like this performed?(Required)
If during surgery it is found that more teeth than estimated are required to be extracted for medical reasons, do you give permission to proceed and contact you after surgery with an update? (If no is chosen, we will be required to call for permission during the surgical procedure.)(Required)
Do you consent to having images taken of your pet if needed or requested?(Required)
Clear Signature
This field is for validation purposes and should be left unchanged.