Follow Up Appointment Form

Fields marked with an * are required
The follow-up appointment form is designed to better serve you and your pet(s) during their follow-up exam with his or her veterinarian. Please be as specific as possible regarding any information you provide.

Owner Information

Is the person bringing in the pet(s) different than the owner? *
Preferred Doctor (Based on appointment availability) *


Patient Information

Was your pet prescribed any medications? *

AUTHORIZATION: ALL FEES ARE DUE AND PAYABLE AT THE TIME SERVICES ARE RENDERED. We accept cash, Visa, Mastercard, Discover, and American Express. In addition, we offer third-party financing through CareCredit and ScratchPay. Please notify a receptionist if you need to apply for third party financing prior to the start of your appointment.

Current vaccinations by a licensed veterinarian are required for the admission of your pet to our hospital. This includes admission for elective surgery, boarding, grooming, and well animal care. Proof of vaccinations is required. If the pet is not current on vaccinations at the time of drop-off, client assumes all financial responsibility for bringing the pet up to vaccine standards for Hernando Animal Clinic. Owner administered vaccinations are not acceptable.

I agree to allow the doctors and staff of Hernando Animal Clinic to treat my pet and I accept responsibility for all accumulated fees associated with the care that my pet(s) receive. I understand that I am responsible for payment in full prior to discharge according to Hernando Animal Clinic policy and will be held responsible for service or collection fees if balance is not paid in full. I have read and accept the above-mentioned terms and conditions by attaching my full name below as my digital signature.