Calhan Veterinary Clinic

(719) 347-2702

13425 N. Calhan Highway, Calhan, CO 80808

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Annual Exam Form

Thank you for entrusting your pet’s care to us today! The following information will be used to help our veterinary team accurately complete your pet’s medical history for today’s visit.
Thank you!
Owner Name*
Who should we contact to make medical decisions today?*
Name*
Reason for visit: (check all that apply)
Does your pet enjoy visiting the veterinary clinic?*
Dog vaccines
Feline Vaccines
Other procedures: (All procedures at additional cost)
Have you noticed any issues/problems with your pet? Are there any concerns for the following: (check all that apply)
Has your pet ever had any adverse reaction to any medications, vaccination, or other procedure?*
How much do you feed?*
If measured amount?*
How much?
How often?
Do you have insurance for your pet?*
Do you give your pet heartworm or flea/tick preventative?*
Do you wish to take home flea/tick/heartworm prevention today?*
Have you seen any fleas or ticks on your pet?*
Do you have other pets?*
Does your pet come into contact with other dogs? Please check all that apply
Is your pet on any medications?*
Was your pet last seen by a veterinarian at Lake Road Animal Hospital?*
Once your pet’s exam is completed, we will review the exam findings and recommendations. I understand that financial responsibilities for services rendered are due at the time of discharge.*
Many of our patients love peanut butter as a snack while visiting our office, but if you or your pet have an allergy to peanut butter, please let us know. Can your pet have peanut butter?*
Social Media/Photo Permission: Do we have your permission to post photos of your pet online?*
I certify that I am 18 years of age or older and responsible for the financial and medical decisions for the above-mentioned pet.*
MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.

Testimonials

Took care of us and my sweet boy Oakley even had a follow up text checking up on my sweet dog the day after. Friendly staff and loved the vet and... read more

Shea W.

This is a great vet. I’m a horse trainer and from time to time I need them to see my clients horses. They always get me a appointment ASAP. They... read more

Mark H.

Wonderful people and the Vet is kind and caring. My dog is deaf so I really want people who will be understanding and handle her gently. Extremely... read more

Sharon S.

Shea W.

Took care of us and my sweet boy Oakley even had a follow up text checking up on my sweet dog the day after. Friendly staff and loved the vet and front desk

Mark H.

This is a great vet. I’m a horse trainer and from time to time I need them to see my clients horses. They always get me a appointment ASAP. They do a great job for my horses and I really appreciate the extra care.

Sharon S.

Wonderful people and the Vet is kind and caring. My dog is deaf so I really want people who will be understanding and handle her gently. Extremely happy with these people!!

Our Location

Calhan Veterinary Clinic

13425 N. Calhan Highway
Calhan, CO 80808

(719) 347-2702

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