New Canine Information
This form is for New Canine patients of Collar and Saddle or Existing Canine patients with a new complaint and/or returning more than 1 year since their last visit.

If you have multiple animals to be seen: Please be sure to include YOUR name on this form, but you do NOT need to re-enter your address and phone number on subsequent forms for each animal.
Canine Fee Schedule: New Patient/New Injury/1+ year since last visit: $80, Existing patient/Follow up visits: $50, Travel Fee ($1/mile over 10 miles from Midlothian center), Multi-Animal discount available ($10/additional canine) *
Required
Client (Owner) Name *
Email Address *
Phone Number *
Address (Please include zip code) *
Animal Name *
Veterinarian Name or Clinic Name (if no specific doctor) *
Veterinarian's Email (if known)
Gender, Intact/Neutered/Spayed *
Breed (list any known) *
Color *
Select Chief Complaint
Explain Above or List Additional Concerns
When did this (these) issue(s) begin?
This issue came on...
Clear selection
Mechanism of Injury (How this issue began)
Explain above or list other specific method of injury.
Past Surgeries (excluding spay/neuter)
Current Medications/Supplements
Previous X-rays/Other Imaging Tests/Information
Previous Care
Additonal Information you feel may help us help your animal:
Permission Form
The State of Texas REQUIRES us to have a veterinary referral to see your animal. Please watch your email inbox for a DocuSign consent form for both you and your animal(s) veterinarian to sign. We may have to first locate your Veterinarian’s contact info, so please allow time for us to obtain this info.

We look forward to working with you and your veterinarian to help your animal feel and function their best!

Collar and Saddle Staff
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