Equine | Otter Point Vet

Equine Application

Name of Owner:

Home Address:

Email:

Phone Number:

Address for horse (if different from home address):

Alternate person able to make decisions on your behalf:

Alternate person's phone number:

Name of Animal:

Age:

Estimated weight (kg):

Colour:

Estimated height (Hands):

Breed:

Gender Options:

Stallion

Gelding

Mare

History

Last physical exam date:

Date of last blook work:

Date of last vaccinations:

Date of last fecal float:

Issues with sedation (easy or difficult):

Any negative reactions to vaccines?

Handling (easy, well behaved, bite, kick, etc):

Medical conditions:

Other notes:

Equine Waiver

Otter Point Veterinary Hospital does not offer emergency services outside of regular office hours. We recommend that clients establish a relationship with a veterinarian who provides after-hours care for emergencies.

During office hours, we may be able to assist with emergencies, depending on the situation. However, please be aware that we only have one veterinarian on duty at a time, and scheduling conflicts may limit our ability to provide emergency care during the day.

Please note that house call fees and special order medications must be pre-paid prior to the appointment.

I acknowledge that I am responsible for establishing a relationship with a veterinarian who provides after-hours care and can offer immediate assistance if necessary.

I understand that if I cancel with less than 72 hours' notice, I will be billed for the farm call fee.

I acknowledge and accept the Equine Waiver above.

Thanks for submitting!