New MRI technology. New neurologist. Welcome, Dr. Tracy Sutton!
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Last Heat Cycle:
How long have you owned this pet?:
Where did you acquire pet?:
Are Vaccinations Current?:
Referring Veterinarian Name:
Reason for Referral (primary complaint):
Please list any of your pet’s drug allergies or special problems that we should know about:
Have any doctors at Austin Veterinary Emergency & Specialty Center, Mission Veterinary Specialists in San Antonio or Gulf Coast Vet Specialist in Houston seen any of your pets in the past?:
If yes, which doctor(s) and which pet(s):
Had you heard about our hospital prior to this referral?:
If yes, how:
Did you bring (or mail in) X-rays and/or medical records from your veterinarian?:
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Yes I am okay with Austin Veterinary Emergency & Specialty Center sharing my pet's picture and story. :
Following the doctor’s examination, we will provide you with an estimate of fees. All professional fees are due at the time services are rendered, with a 75% partial payment required to begin diagnostics, surgery, and/or treatment. We accept cash, check (with appropriate identification and check approval), and all major credit cards.. There will be a service charge for any check returned unpaid. We urge you to discuss all fees with the doctor before services are performed.
Austin Veterinary Emergency & Specialty Center is comprised of multiple practices within the building. Charges that are assessed for your pet will be billed separately through each appropriate practice. If you have any questions, please be sure to ask any of our front desk staff.
What symptoms have you observed at home?
How long have the symptoms been present?
Did the symptoms start suddenly?
Are the symptoms:
ProgressingStaying the sameImproving
Is your pet otherwise normal?
Are there other medical problems we need to know about?
Has your pet had any previous surgery other than spay or neuter?
Is your pet on any medication?
What medication(s) has your pet taken for this problem in the past?
If medications are being used to treat the condition for which we are evalutating your pet, have they been associated with any improvement in the condition?
Have medications been previously used that were NOT successful?
Please list ALL medications your pet currently taken for UNRELATED problems
Did you bring any radiographs or lab test results?
Did you bring any Medical Records?
What kind of food do you feed your pet?
What types of snacks/treats do you feed your pet and how often?
Do you have other pets?: