Welcome to Care Animal Hospital of Pleasant Prairie. We appreciate your interest in our services and look forward to meeting your pet. A completed registration form and your pet's complete records (both vaccine information and medical chart) are require. This helps to give us valuable insight in providing optimal care for your pet(s). Once all is received our staff will then contact you to schedule your pet’s appointment. The required sections have a red * asterisk.

Owner's Name
Name
Please specify if the phone number is
Please specify if the phone number is
Name
Please specify if the phone number is
Please specify if the phone number is
Late Arrivals: If you are more than ten (10) minutes late for your pet's appointment, our staff will ask your doctor to help determine when best to see you. You may be worked into the schedule with or without a wait, you may be given the next available appointment or it may be necessary to reschedule.
Advance Notice: If you wish to change or cancel an appointment, we appreciate a 24-hour advance notice. If you wish to change or cancel an admission appointment to our hospital, we appreciate a 48-hour notice. Advance notice allows another pet to use the appointment time. Appointments canceled less than 24 hours before the scheduled time may be considered a missed appointment.
Missed Appointments: If you miss your first appointment as a new client without 24-hour notice, you may not be accepted into this practice. If you are an established client and miss three or more appointments within a year without 24-hour notice, you will be asked to pre-pay for the exam which can only be used on the date scheduled.
Wisconsin law (Stat. 453.075) requires written permission to release your pet's health records to certain third-parties (non-owners) such as boarding facilities, rescues, and other veterinary clinics. Do you authorize us to release your pet's health records.
I consent to Care Animal Hospital taking photographs and videos of my pet for educational and marketing purposes. I waive any claims or rights of compensation or ownership regarding such uses and understand that all media shall remain the proper of Care Animal Hospital.
I consent to Care Animal Hospital contacting me by e-mail and by text message for the purposes of health information and reminders. I will update my number or notify Care if it’s no longer in my possession.
Pet Information
If intact female, any litters or clutches?
Does your pet have access to the entire house?
Is your pet:
This is to help us visualize how the space is allocated for the various activities that your pet may perform on a daily basis (e.g. hiding, basking, soaking, feeding, playing, etc.). If you utilize lights (UVB, heat lamps, and/or traditional lighting), under heat mats, misting systems, etc., it is helpful to see where those are located in terms of where your pet likes to spend the majority of their time. It also helps us to see how you are monitoring the temperature and humidity and how you are feeding. Knowing where the enclosure is within or outside of the house and where it is in relation to other pet enclosures that you may have, is also useful. Thank you for helping us provide the best care that we can for your pet!
One file only.
100 MB limit.
Allowed types: gif, jpg, png, svg.
Is your pet supervised when out of its enclosure?
Is Lighting Timer Controlled?
As Fear Free certified professionals, we want to make your visit to our hospital the best it can be for you and your pet. Please answer a few questions so we can consider both your and your pet’s preferences for the visit. Please bring a special treat from home that we can give your pet during the appointment to create a positive experience.
Complete records means both vaccine information and medical chart. We will not offer shelter/rescue/AKC first free exam discounts unless the certificate is present at the first appointment.
Drop files here
One file only.
100 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.
We are able to add your pet's picture to their medical record. This is optional and is not required.
One file only.
100 MB limit.
Allowed types: gif, jpg, png, svg.
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