OFA Pet Pre-registration - CVETS - Columbia Veterinary Emergency Trauma and Specialty

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OFA PET PRE-REGISTRATION

Get Set Up For Care.

To make this appointment easier, we have created a form for you to fill out so we have everything we need ahead of time! Please fill out the fields below to expedite the Database Application Submission for your pet's appointment.

Owner Name*
First Last
Co-Owner Name (If applicable)
First Last
Primary Phone*
SMS Text Agreement
I agree to receive text updates and reminders.
By checking this box, I agree to receive SMS/text messages from CVETS to the mobile number provided above. I understand I am not required to provide consent for texting as a condition of treatment. Reply STOP to cancel. Message and data rates may apply.
Additional Phone Numbers
Email*
Preferred Method of Contact*
- Call
- Text
- Email
Address*
No PO boxes per DEA guidelines.
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Are you active or retired military, law enforcement, or veterinary professional?*
- Yes, Military
- Yes, Law Enforcement
- Yes, Veterinary Professional
- No
Have any of your pets been seen at CVETS before?*
- Yes
- No
How did you hear about CVETS?*
- Referral
- Social Media (Facebook, Instagram, Twitter)
- Television/Print Advertisements
- Other
Payment Policy & Treatment Consent*
I agree to the privacy policy and treatment consent.
I understand and agree to authorize the veterinarian to examine, prescribe for and provide initial diagnostics for my pet. I am aware a deposit may be required prior to work up. All accounts must be paid at time of discharge. I am 18 years old or older and am accepting financial responsibility for this patient’s medical care and assume responsibility for all fees associated with the collection of any unpaid balance.
Photo, Video, and/or Recording Consent*
CVETS or its officers, employees, or agents may take photos of patients for education, advertising, media, video, audio or other marketing purposes.
- I DO authorize photos, video, or recordings of my pet.
- I do NOT authorize photos, video, or recordings of my pet.
Pet Name*
Registered Name*
Date of Birth*
Spay/Neuter/Intact*
Species*
Breed*
AKC Registration Number or Other Registry Name/Number*
Microchip or Tattoo Number*
Registration Number of Sire*
Registration Number of Dam*
Color*
Primary Veterinarian Practice Name*
Primary Veterinarian Name*
Type(s) of Examination:
- Application for Hip/Elbow Displasia Database
- Application for Patellar Luxation Database
- Application for Thryoid Database
- Application for Basic Cardiac Database
- Application for Advanced Cardiac Database
Please list all medications that your pet is currently on, including herbs and/or supplements below, as well as their last dosage.*
Name
This field is for validation purposes and should be left unchanged.

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Urgent and Emergency Care
Meet The Doctors
Specialties
Pet Owners
For Vets
More

Call: 803-995-8913
Directions
Online Payment
CVETS Connects
Online Referral
Employee Login

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facebook
linkedin
instagram