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Shaker Veterinary Hospital, P.C. 223 Maxwell Road, Latham, New York 12110 Tel: (518) 4589669 Fax: (518) 4536107 www.shakervet.com Office Use Only Chart#: Date: Acupuncture/Chiropractic Intake Form
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How to fill out Shaker Veterinary Hospital PC:

01
Start by writing your full name, address, and contact information at the top of the form.
02
Fill in the date of the visit or the date you are completing the form.
03
Provide information about your pet, including its name, breed, age, and any identification numbers, such as microchip or registration numbers.
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Indicate the reason for the visit or any specific concerns or symptoms your pet is experiencing.
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Fill in your pet's medical history, including previous vaccinations, surgeries, medications, and any known allergies or pre-existing conditions.
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Provide information about your pet's diet, exercise routine, and behavior.
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If applicable, include details about any pet insurance you have for your pet.
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Sign the form to confirm that all the information provided is accurate and complete.

Who needs Shaker Veterinary Hospital PC:

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Pet owners who are seeking veterinary care for their pets.
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Individuals who want to have their pets examined, vaccinated, or treated for any medical conditions.
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People who are looking for a reliable and trusted veterinary hospital to provide quality care for their pets.
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Shaker Veterinary Hospital PC is a veterinary hospital located in Shaker Heights, Ohio.
The owners or operators of Shaker Veterinary Hospital PC are required to file.
To fill out Shaker Veterinary Hospital PC, you will need to provide information about the hospital's finances, operations, and any other relevant details.
The purpose of Shaker Veterinary Hospital PC is to report financial and operational information about the hospital.
Information such as revenue, expenses, employee salaries, and any other financial or operational data must be reported on Shaker Veterinary Hospital PC.
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