440-708-2828 chagrinanimalclinicstaff@gmail.com

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Please Note: We will be closing early on Tuesday, 24th December at 1 PM and closed on Wednesday, 25th December in observance of Christmas!

Online Form

Drop Off Form

Save time during your next appointment! Complete your required forms online from any device at any time before your visit.

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Drop Off Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit. If this is an emergency, or if your pet needs urgent care, please call us at 440-708-2828 for a faster response.

Name *

First

Last

Email *

Phone *

Pet's Name *

Species *

Dog
Cat

Breed *

Age *

Sex *

Male
Neutered Male
Female
Spayed Female

What will we be seeing your pet for today? *

Primary Complaints *

Vomiting
Diarrhea
Difficulty Breathing
Growth/Lump
Blood in Urine
Blood in Stool
Itching
Eyes
Ears
Hair Loss
Lameness/Limping
Increased Thirst
Coughing
Sneezing
Painful
Inappropriate Urination
Lethargic
Difficulty Urinating
Other

Please Explain. *

If your pet has any unsual lumps, bumps, wounds, or skin irritation that you would like the doctor to address today, please note the location(s) here:

Was your pet fed today? *

Yes
No

Time of meal? *

Is your pet current on vaccines? *

Yes
No

Any previous injury or illness?

Please list any medications your pet is currently on.

Is your pet on heartworm/flea and tick medication? *

Yes
No

What type of heartworm and flea/tick medication is your pet using? *

Last given: *

What type of diet do you feed your pet? How much and how often? *

Please describe any other issues you would like addressed today.

If doctor recommended, we may need to perform labwork depending on symptoms. *

Yes, please run the tests.
No, not at this time.
Please call me first.

If doctor recommended, we may need to perform diagnostic testing, such as x-rays. *

Yes, please run the tests.
No, not at this time.
Please call me first.

I hereby give my consent to the Chagrin Animal Clinic to perform an exam and treatment(s). *

I have read and understand.

Date *

Phone

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Book an Appointment

Book your next appointment at Chagrin Animal Clinic right from your phone or computer. We look forward to seeing you!

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Download Our App

With our new app, you’ll have all of your pet’s health information in the palm of your hand, and you’ll be able to communicate with our team much easier.

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Visit Our Online Store!

Buy your pet’s medication and food in one easy, online visit! Click the button below to start shopping for your pet’s favorite products!

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Have a question?

Complete our online form, and a member of our team will be in touch with you shortly.

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Location

16680 West Park Circle Dr
Chagrin Falls, OH 44023

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Hours

Mon–Fri: 8:00 am – 6:00 pm
Sat: 8:00 am – 12:00 pm
Sun: Closed

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Contact

440-708-2828
440-708-2835 (fax)
chagrinanimalclinicstaff@gmail.com

Name *

First

Last

Email *

Phone

How can we help you? *

Phone

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