Reptile Medical History

  • Date Format: MM slash DD slash YYYY
  • Diet

  • Water

  • Housing

  • Handling

  • STATEMENT OF FINANCIAL RESPONSIBILITY

  • I am aware that I am responsible for all charges related to medical services that my pet receives at Brook-Falls Veterinary Hospital & Exotic Care.. I understand that I will be asked to leave a deposit for medical services should my pet require a hospital stay. I understand that I must pay in full at the time medical services are completed. I have been advised that any charges revealed during post care audits will be invoiced in a timely manner and remain my financial responsibility.
  • Date Format: MM slash DD slash YYYY