780-250-1700
2531 – 17th Street NW Edmonton, AB
Links
Become A Client
Surrender Consent Form
Hit enter to search or ESC to close
Home
Contact
New Clients
What to Expect
New Client Registration Form
Prescription/Food Refill Request
About Us
Team and Pet Bios
Location & Hours
Make an Appointment
Fear Free Clinic
Services
Medical Services
Surgical Services
Anesthesia and Patient Monitoring
Nutritional Counseling
Additional Services
Pet Health
Pet Health Library
Pet Health Checker
How-To Videos
News
Forms
Consent Forms
General Anesthesia Consent
Euthanasia Consent Form
Echocardiogram – Drop Off Consent Form
Drop Off Consent Form – with sedation
Drop Off Consent Form
Overnight Hospitalization – Drop Off Consent Form
Blood Glucose Curve – Drop Off Consent Form
Dental Surgery Consent Form
Spay/Neuter Surgery Consent Form
Telemedicine Consent Form
Ultrasound Consent Form
Admission Forms
Canine Patient Admission Form
Feline Patient Admission Form
Recheck Exam Admission Form
Questionnaires
Diarrhea Questionnaire
Vomiting Questionnaire
Itching Questionnaire
Canine Cognitive Dysfunction Syndrome Assessment
Shop Online
Feline Patient Admission Form
CAT INTAKE
Patient’s Name
*
First
Last
Patient's age
*
Please specify years, months, or weeks
Sex
*
Neutered Male
Intact Male
Spayed Female
Intact Female
Breed
*
Reason for appointment
*
Duration of primary concern?
*
Do any family members have food allergies as we use treats with our patients?
*
Does your pet have any food allergies?
*
Does your pet have anxiety issues in veterinary clinics or during transport?
*
Please describe below as we often will give medication to ease the fear, anxiety and stress associated with the visit
Is your pet insured, if so please list company and policy so we can facilitate your claim
*
CONTACT INFORMATION
Are there any changes to your contact information (if a returning patient)?
No
Yes
Phone
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Email
ILLNESS PROTOCOL
We respectfully request that you wear a mask in the clinic during the appointment if you are feeling ill.
Owner Signature
*
HEALTH HISTORY
Has your cat been vaccinated/dewormed anywhere else besides Tamarack Veterinary Clinic since your last visit here?
*
Yes
No
What other pets live in the house?
*
Does your pet:
*
Attend Boarding Kennels
Attend Daycares
Receive Grooming
Travel Outside of Alberta
Have Exposure to Rodents
None of the Above
Hold the CTRL button to select multiple options.
How many litter pans do you have in the house?
*
Does your cat go outside or live with another cat that does?
*
Yes
No
Brand and type of food fed (canned/dry)?
*
Which treats do you offer your cat?
*
Are you giving any prescription or non-prescription medications or supplements to your cat
*
Has your cat had any adverse drug reactions previously?
*
Is your cat experiencing any coughing/sneezing/vomiting/diarrhea or experiencing any change in drinking/urination/appetite?
*
Does your cat have any behavioral concerns?
*
Consent
FOR NEW CLIENTS/PATIENTS ONLY - I hereby grant Tamarack Vet Clinic LTD permission to take photographs of myself and/or my pet(s), and to publish those photographs for any lawful purpose, including but not limited to, their website, social media accounts, and promotional materials, either digital or in print, in perpetuity. I also grant permission to use my name and/or my pet(s) name.
By signing and dating this document, I authorize Tamarack Vet Clinic LTD to edit, alter, share, remix, tweak, build upon or in any way alter the photograph(s) mentioned above. I also waive any rights of privacy or compensation associated with the use of my or my pet(s) images(s) and name(s) for the personal or commercial purposes outlined above.
Cancellation Policy
With increased demand for appointments as well as increased no-show and last-minute cancellations, we require 24 hours notice for appointments and 72 hours notice for any surgical booking cancellations. Special circumstances will be evaluated on a case-by-case basis.
*
I understand
If you have a history of no-show appointments or late cancellations, you will be asked to pre-pay the exam fee or 25% prepayment of any surgical estimate prior to any future bookings. If the cancellation/no-show policy is not adhered to, the deposit is not refundable.
*
I understand
Please be 10 minutes early for your appointment and ensure that all pertinent medical records are transferred to us PRIOR to your appointment. If you are more than 10 minutes late for your appointment, we will have to reschedule your appointment. Please take this into consideration when booking a time. This affects sick and routine annual appointments.
*
I understand
Patients must be on a leash or in a carrier while in the clinic. Please call from your car if you have left these items at home. Please call the clinic prior to entering with any fearful or reactive patients so we can help to ensure a fear-free experience for every patient.
*
I understand
Owner Signature
*
Date
*
Date Format: MM slash DD slash YYYY
Home
Contact
New Clients
What to Expect
New Client Registration Form
Prescription/Food Refill Request
About Us
Team and Pet Bios
Location & Hours
Make an Appointment
Fear Free Clinic
Services
Medical Services
Surgical Services
Anesthesia and Patient Monitoring
Nutritional Counseling
Additional Services
Pet Health
Pet Health Library
Pet Health Checker
How-To Videos
News
Forms
Consent Forms
General Anesthesia Consent
Euthanasia Consent Form
Echocardiogram – Drop Off Consent Form
Drop Off Consent Form – with sedation
Drop Off Consent Form
Overnight Hospitalization – Drop Off Consent Form
Blood Glucose Curve – Drop Off Consent Form
Dental Surgery Consent Form
Spay/Neuter Surgery Consent Form
Telemedicine Consent Form
Ultrasound Consent Form
Admission Forms
Canine Patient Admission Form
Feline Patient Admission Form
Recheck Exam Admission Form
Questionnaires
Diarrhea Questionnaire
Vomiting Questionnaire
Itching Questionnaire
Canine Cognitive Dysfunction Syndrome Assessment
Shop Online
Contact Us
Name
*
First
Last
Email
*
Phone
*
Pet Name
*
Preferred Date
*
MM
DD
YYYY
Preferred Time
*
:
HH
MM
AM
PM
Reason for appointment
*