Medical Form
Email address *
Human Name *
Your answer
Dog's Name *
Your answer
Veterinarian Name
Your answer
Medication Supplement Name
Your answer
This medication treats what condition/ailment?
Your answer
This is an:
Dosing Information
As Needed**
**Explain how we will know your dog needs this medication/supplement?
Your answer
Explain how you give your dog this medication/supplement and what you are providing us to "hide" it in.
Your answer
Please note: You must provide a way for us to administer the medication to your dog (i.e. Pill Pocket, lunch meat, cheese, peanut butter, etc., however your dog normally takes her/his medications). We will NOT force the pills down your dog's throat, both for your dog's safety and for ours.
Additional notes:
Your answer
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