Name: Spring Meadow Animal Clinic
Address: Helena, MT 59601, Helena, MT, 59601, US
Telephone: 406-449-3539
Price range: $$

Drop-Off Information Form

The information requested would inform us of how we can best care for your pet. It is the only way we can be certain that we understand what you want. Therefore, it is very important for you to be as specific as possible. If we need additional information, we can reach you at the number you give us today. Thank you.

Today's Date*
Date Format: MM slash DD slash YYYY
Owner's Name*
First Last
Pet's Name*
Phone number where you can be reached today:*
When was the last time your pet ate?*
History
Chief Complaint or Reason for visit:
Duration of Chief Complaint:*
Is your pet taking any Medications/Vitamins/Supplements/Herbs:*
Have you seen your pet passing worms?*
- Yes
- No
If Yes, describe:
Has your pet had any injury or illness in the past 30 days?*
- Yes
- No
If Yes, describe:
Does your pet have a history of seizure activity?*
- Yes
- No
If Yes, describe:
Please Check any/ all of the symptoms your pet is displaying:*
- Vomiting
- Diarrhea
- Coughing
- Sneezing
- Gagging
- Scratching/ rubbing
- Scooting
- Shaking head
- Unusual discharge
- Lethargy
- Bad breath
- Lameness/ limping
- Difficulty rising
- Unusual lumps
Any noticeable changes in appetite, water consumption, bowel movements or urination?*
- Yes
- No
If Yes, describe:
Additional concerns/comments
Please call the office by 3:00 p.m. to check on progress and in case we have not been able to get in touch with you.
OWNER RELEASE:*
I agree to the release policy.
The clinic and staff will NOT be held liable for any problems that develop provided reasonable care and precautions are followed. I understand that ANY problem that develops with my pet while I’m absent will be treated as deemed best by the staff veterinarians, and I assume full responsibility for the treatment expense involved. By checking this box I agree to the above in full.
Consent Date*
Date Format: MM slash DD slash YYYY
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Contact

P: 406-449-3539
E: smac@springmeadowac.com
F: 406-442-0981

Location

1660 Euclid Ave
Helena, MT 59601

Hours

Monday-Friday: 8 AM- 5:30 PM
Saturday & Sunday: Closed

Emergency Info

Drop-Off Information Form

History

Please call the office by 3:00 p.m. to check on progress and in case we have not been able to get in touch with you.

Contact

Location

Hours