Hospitalization Form

Please fill out the following form as thoroughly as possible before your scheduled appointment with us. You can also download a printable version of the form here. If you have any questions, please feel free to call us at 858-792-3888. Please note: All * fields are required.

Client's Name *

First

Last

Email *

Pet's Name *

If cat, is your pet (check all that apply):

Indoor
Outdoor
Contact with outside cat

Reason your pet is to be examined by the doctor: *

Duration of Problem: *

Is the problem: *

Better
Worse
Same

Has your pet been seen recently by another doctor for this condition? *

Yes
No

Has your pet eaten today? *

Yes
No

Has your pet had any medication today? *

Yes
No

Has there been a change in diet recently or any treats given? *

Yes
No

Other information or instructions for the doctor:

Do we have permission to proceed with tests and/or treatment before calling you? *

Yes - Proceed to treat without calling.
Yes - Proceed to treat without calling but do not exceed a price point without notifying me first.
No - may mean delays in treating your pet if we have trouble reaching each other on the phone.

There is an initial fee for hospitalization.
I give permission to treat my pet as noted in the above form. If anesthesia and/or surgery are required, I authorize it and accept the risks. I also understand that my pet will be examined as soon as time allows between scheduled appointments and surgery, but not at a scheduled time.

Checkboxes *

I agree.

Signature *

Date *

We're proud to serve Del Mar, CA and the surrounding communities.

Name: Del Mar Heights Veterinary Hospital
Address: 2626 Del Mar Heights Rd Ste B, Del Mar, CA, 92014, United States
Telephone: 858-792-3888
Price range: $

As a community-focused veterinarian in Del Mar, CA, we offer a new level of full-service veterinary medicine at our hospital. We treat each and every four-legged family member as though they were our own.

Location

2626 Del Mar Heights Rd Ste B
Del Mar, CA 92014
Click here for directions.

Contact Info

Text: 858-792-3888

Phone: 858-792-3888
Fax: 858-792-5161
Email: [email protected]

Hours

Mon - Fri: 8:30 am - 5:30 pm
Sat: Closed
Sun: Closed

Please note: We will be closed on Saturdays until further notice.

Hospitalization Form

Hospitalization Form

We're proud to serve Del Mar, CA and the surrounding communities.

As a community-focused veterinarian in Del Mar, CA, we offer a new level of full-service veterinary medicine at our hospital. We treat each and every four-legged family member as though they were our own.

Location

Contact Info

Hours

Have a question?

Book an Appointment Online!

Book your next appointment with us online in minutes.

We look forward to seeing you soon!