Home
About
Services
Online Pharmacy
Client Center
Join Our Team
Contact
- Call
- Email
Book Appointment

Call: 410-522-9090

Text: 410-522-9090

2304 Boston Street Baltimore, MD 21224

Home
About
Services
Online Pharmacy
Client Center
Join Our Team
Contact
- Call
- Email
Book Appointment

Surgery / Sedation / Anesthesia Form

Please complete this form before your visit.

Owner's Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Primary Phone *

Secondary Phone

Email *

Pet's Name *

When did your pet last eat? *

Is your pet on any medication? *

Medication Name *

Medication Dosage *

Medication Frequency *

When was the last dose given? *

When is the next dose due? *

Add another medication? *

Medication Name *

Medication Dosage *

Medication Frequency *

When was the last dose given? *

When is the next dose due? *

Add another medication? *

Medication Name *

Medication Dosage *

Medication Frequency *

When was the last dose given? *

When is the next dose due? *

Is your pet microchipped? *

If no, would you like them microchipped while they’re here? *

Do you need any refills of heartworm/flea/tick prevention? *

Will you be leaving anything with the pet?

(Ex: leash, collar, harness, toys, etc)

In the case of an emergency, would you like us to perform resuscitation? Please be aware that every effort will be made to contact you immediately in this situation. *

I authorize life-saving measures up to: *

$500
$1000
Unlimited

Please be aware that every effort will be made to contact you immediately in this situation.

I have read, understand and approve the estimate for my pets procedure. *

Signature *

Date *

Exceptional Pet Care in Baltimore!

Your pet deserves only the finest veterinary care available and Harbor View Veterinary Hospital is committed to treating your pet with care, compassion, and the latest veterinary medical techniques.

Contact Us



Text: 410-522-9090

Phone: 410-522-9090
Fax: 443-440-6244



[email protected]



2304 Boston Street
Baltimore, MD 21224

Hours

Mon: 8:00am – 5:00pm
Tues: 8:00am – 2:00pm
Wed: 8:00am – 5:00pm
Thurs: 8:00am – 5:00pm
Fri: 8:00am – 5:00pm
Sat – Sun: Closed

Book Appointment