Drop Off Form

Pet's Name

Owner's Name

First Name

Last Name

Reason for Visit

Date of Visit

If fleas are found on my pet, flea prevention will be applied and charged to my account.

Pickup will be after 3pm

I understand

RELEASE/CONSENT SIGNATURE

I, THE UNDERSIGNED DO HEREBY CERTIFY THAT I am the owner, or assuming responsibility, financial or otherwise, for the animal being presented to Friendswood Veterinary Hospital for the treatment and care should it be needed. I hereby consent and authorize Friendswood Veterinary Hospital to receive, prescribe, or treat, as indicated, this animal. It is thoroughly understood that I assume all the risk. Friendswood Veterinary Hospital has permission to do whatever is necessary should an emergency arise until I am reached.

Signature

Clear

Best Contact Number

Name

First Name

Last Name

Are you an authorized representative over 18?

Yes

No

If you are human, leave this field blank.

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Hospital Hours
Monday - Friday 8:00-5:00
Saturday CLOSED

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Hospital Address
111 Woodland Trail Dr.
Friendswood, TX 77546

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Hospital Phone
(281)993-4417
Fax (281)993-4236
After-Hour Emergencies