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McPhillips Animal Hospital Winnipeg Manitoba
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Pet Illness Medical History Form

Please read through the following questions and answer any that may apply to your pet. Please read and sign this form.
  • Date Format: MM slash DD slash YYYY
  • Please include name of medication, amount given and time given.
  • Please include name of medication, amount given and frequency given.
  • Include when it started
  • **Please note that if we have not seen your pet before, we will need to be able to contact you regarding your pet’s examination prior to instigating any treatments.
  • I am the owner/agent for the described animal; I authorize and request an exam for my pet.

    I understand the veterinarians and/or staff at McPhillips Animal Hospital will contact me after my pet’s examination to discuss recommended diagnostics and treatment. If requested, all efforts will be made to reach me prior to the administration of any treatments prior to them being performed. If I cannot be reached, I authorize initial treatment, including fluid support and other supportive medications, to be started as indicated for my pet.

    I understand that during the performance of the examination and potential procedures, unforeseen conditions may arise that necessitate additional or different procedure(s), operation(s), or treatment(s) than those set forth. Therefore, I hereby consent to and authorize the performance of such as are necessary and desirable in the exercise of the veterinarian’s professional judgment.

    I understand and accept that when sedation and/or anesthesia are involved, there are always inherent risks including death.

    The nature of the examination/diagnostics has been satisfactorily explained to me and no guarantee has been made as to the result or cure. I understand there may be risk involved in these procedures.

    I understand that I will be charged for flea medication and a dose will be applied if evidence of fleas is found on my pet today.

    I understand that payment is due when my pet is discharged; however, a deposit may be required after an estimate is prepared and discussed. I accept financial responsibility for charges incurred for this pet.

APPOINTMENTS

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HOSPITAL HOURS

Monday 8 am to 6 pm
Tuesday 8 am to 6 pm
Wednesday 8 am to 6 pm
Thursday 8 am to 6 pm
Friday 8 am to 6 pm
Saturday 8 am to 2 pm

Please note that our last available appointment on Fridays is 5PM

CONTACT US

2211-B McPhillips St.
Winnipeg, Manitoba, R2V 3M5

Tel: (204) 589-8381
Email: mcphillipsanimalhospital@gmail.com

DIRECTIONS

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  • New Clients
    • What to Expect
    • Virtual Tour
    • Referral Rewards
    • Make an Appointment
    • Scheduling
    • Promotions
    • New Client Form
    • Pet Medical History Form
  • About Us
    • Location & Hours
    • Our Team
    • Join Our Team
    • For Pet Owners
    • FAQs
  • Services
    • Wellness and Vaccination Programs
    • Medical Services
    • Surgical Services
    • Pet Health Information
    • Anesthesia and Patient Monitoring
    • Euthanasia/Cremation
    • Specialist Reviews
  • Pet Health
    • Educational Articles
    • How-To Videos
    • Pet Health Checker
    • Pet Insurance
    • News
    • FAQs
  • Forms
  • Webstore