About this template
Streamline patient check-ins at your animal hospital or veterinary clinic using this comprehensive Veterinary Intake Form. Designed for front desk staff and veterinarians, this digital intake form collects essential owner contact details, pet vital information, medical histories, current medications, dietary habits, and preventative care records before the examination begins.
Gathering accurate pet health data upfront reduces waiting room bottlenecks, minimizes administrative errors, and gives your veterinary team immediate insight into any symptoms, past conditions, or vaccination sensitivities. Pet owners can easily complete the form on their phones or tablets prior to arrival or right from the waiting room. With Doc2Form, you can instantly convert this template into a Google Form, making it simple to organize responses, store records securely in your Google Drive, and share notes with your veterinary staff.
Key features
- Collect complete pet medical histories and current symptoms in advance
- Capture dietary habits, medications, and preventative care details
- Include consent fields and terms acceptance for treatments
- Mobile-friendly layout for easy completion by clients in the waiting room
- Instantly save and organize all patient submissions directly in Google Drive
Use cases
New patient registration at veterinary clinics and animal hospitals
Gathering pre-appointment symptom checks and medication lists
Collecting client consent for flea, tick, and preventative care treat…
Collecting client consent for flea, tick, and preventative care treatments
Documenting surgical and procedural waivers
What this form collects
- Owner's Full Name (Short answer)Enter your first and last name.
- Primary Phone Number (Short answer)Enter the best number to reach you during the day in case we need to call regarding your pet.
- Secondary Phone Number (Short answer)Optional alternative contact number.
- Pet's Name (Short answer)Enter your pet's name.
- Diet & Feeding Information (Paragraph)List the brand of food, feeding schedule, and any treats or table scraps your pet regularly consumes.
- Current Symptoms or Main Reason for Visit (Paragraph)Describe any symptoms your pet is currently experiencing or the purpose of today's visit.
- Symptom Duration & Frequency (Short answer)How long have you noticed these symptoms, and how often do they occur?
- Current Medications & Supplements (Paragraph)List all prescription medications, over-the-counter drugs, and supplements your pet currently takes, including dosages.
- Previous Vaccination Reactions (Multiple choice)Has your pet ever experienced an adverse reaction to a vaccine or medication?
- Approved Preventative Care (Checkboxes)Select the preventative treatments you would like authorized during today's visit if due.
- Additional Issues or Concerns (Paragraph)Note any other behavioral, medical, or grooming concerns you would like the veterinarian to address.
- Terms and Financial Policy Acceptance (Multiple choice)I confirm that the information provided is accurate and that I am financially responsible for all charges incurred during treatment.
- Electronic Signature (Short answer)Type your full legal name to serve as your electronic signature.
FAQ
How can I customize this veterinary intake form for my clinic?
Once you import the template using Doc2Form, you can freely edit, add, or remove questions directly in Google Forms to match your practice's specific protocols.
Can pet owners fill this out on their mobile phones?
Yes, Google Forms are fully responsive and work seamlessly on smartphones, tablets, and computers, allowing clients to complete the form from home or in your waiting room.
Where are the form submissions stored?
All responses are automatically collected in a linked Google Sheet and stored in your Google Drive, making it easy to review patient details before an exam.
Can I add custom consent agreements and digital signatures?
Yes, you can include text blocks for clinic policies, terms acceptance checkboxes, and short answer fields for client signatures.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.