Online Forms

Complete Your Forms in Advance for a Smoother Experience

Stress-Free Visits Start Here

Save time and reduce stress by filling out your pet’s forms before your visit. Whether you’re coming in for a check-up, surgery, or boarding, completing the necessary paperwork ahead of time helps streamline your check-in process—so you can focus on your pet instead of paperwork. Simply download, print, and fill out your forms, then email them to us at email@bocapalmsanimalhospital.com or bring them with you to your appointment. We can’t wait to welcome you and your furry friend!

New Patient Registry Form

Avian Patient History Form

Exotic Reptile History Form

Exotic Mammal History Form

Pre-Employment Screening Form

Volunteer Pre-Screening

Medical
Proxy Form

At Boca Palms Animal Hospital, we want to make your visit as smooth and stress-free as possible. By completing your forms at home, you’ll help us gather important details about you and your pet before you arrive. This allows our team to update records efficiently and focus on what truly matters—providing the highest level of care for your furry family member. Thank you for helping us create a seamless experience for you and your pet!

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Exotic Reptile History Form

Owner's Name:

Owner's Name:

Pet Information:

Pet's Name:

Species/Sub-Species:

Age/DOB

Gender:

Duration in owner's care/captivity:

Origin (captive bred, wild import):

Source (breeder, pet shop):

Enclosure/vivarium specifications:

Type (arboreal, terrestrial, aquatic):

Size:

Construction (materials, fittings):

Decor and furnishings:

Cleaning routine (agents used):

Environment:

Heating equipment:

Lighting equipment:

Daytime temperature gradient:

Nighttime temperature gradient:

Water temperature:

Photoperiod:

Humidity:

Diet:

Type and quantity:

Frequency of feeding:

Time when food is offerred:

Changes of appetite:

Water:

Method of provision (spray, bowl):

Frequency of water changes; water quality:

Changes in drinking behavior:

Type and frequency of use:

Supplements in water or food:

Breeding details:

Other specimens in same vivarium:

Other specimens in same room or air space:

Disease history of presented animal:

Details of any disease in-contact animals:

Quarantine protocol:

Other details of relevance:

Exotic Mammal History Form

Owner's Name:

Owner's Name:

Date Filled:

Pet Information:

Pet's Name:

What type of animal is your pet?

How long have you had your pet?

Purpose of this visit:

Wellness/Annual New Pet Sick/Injured Second Opinion

Medical History:

Previous veterinarian (if any):

List existing or previous medical conditions:

List of any medications that are being given:

Diet:

What is offered and what is eaten (include brand names, frequency of feeding, and method of feeding)? Please be specific:

What supplements or vitamins are given? How much/how often?

Water:

How is water provided (dish, bottle)?

How often is the water container refilled?

How often is the water container cleaned?

Housing:

List the size and type of cage (aquarium, wire cage etc.)

Type of bedding:

Frequency of cleaning:

Cleaning products used:

Are other animals kept in the same cage with this pet?

Yes No

What other pets are in the household?

Handling:

Is it allowed out of the cage?

Yes No

Who handles this pet, and how often? (If children, please list ages):

Additional comments/concerns:

Ferrets Only:

Date of last Distemper vaccination:

Date of last Rabies vaccination:

Medical Proxy Form

Owner Information:

Date Filled:

Address Information:

Contact Information:

Proxy Information:

Proxy First Name:

Proxy Last Name:

Relationship To Owner:

Phone:

Emergency Phone:

Pet Information:

Pet Name:

Pet Age:

Pet Breed:

Pet Sex:

Male Female

Spayed/Neutered:

Yes No

Other pets at home:

Primary Care Veterinarian:

Phone:

Referring Veterinarian:

Phone:

Resuscitation Directive:

Cardio-pulmonary resuscitation (CPR) is a difficult subject for many people, but one that is very important to review. Emergency cases treated at BPAH must have a resuscitation directive. We are requesting that you choose whether or not you want us to perform lifesaving procedures on your pet in the unlikely event that your pet experiences respiratory and/or cardiac arrest. We will be able to initiate our efforts without delay. Once we have initiated CPR, we will inform you to make further decisions. Prior to making this decision, please consider the fact that animals that have been successfully resuscitated are extremely critical and unstable. The likelihood of re-arrest is high. Management of a pet after successful initial resuscitation requires vigilant monitoring for 24 to 48 hours. Once we stabilize your pet, transfer will be arranged to another animal hospital or 24 hour facility.

Please choose from the following options and initial appropriate box:

Attempt Resuscitation: This choice indicates that you authorize all efforts and procedures determined to be appropriate by the veterinarian to try to resuscitate your pet. CPR is more likely to be successful in a previously healthy, young patient and specific recommendations may be made based on your pet’s condition. If CPR is effective, there are often problems that need to be addressed after resuscitation. CPR does not resolve any underlying diseases. It is important that you know the cost of the CPR starts at $400 and the total will vary depending on your animal’s needs. This and the cost of any additional care after the CPR are in addition to your current estimate. Do Not Resuscitate: Every attempt will be made to prevent a cardiac and/or respiratory arrest from occurring, but if your animal arrests, no CPR will be performed. This option is always an acceptable choice based upon your beliefs and needs.

I have read and understand the CPR options above and in the event my pet experiences respiratory and/or cardiac arrest. I (we) authorize BPAH to act according to my choice above and to begin necessary measures for treatment immediately upon arrival.

Pet Name:

Owner's First Name

Owner's Last Name

Date Signed:

Proxy's First Name

Proxy's Last Name

Date Signed:

DEPOSIT:

$500 deposit to cover lifesaving emergency currently underway to stabilize your pet. This deposit will be applied against the final costs of care.

We will keep a copy of your credit card and your driver’s license on file in order to process emergency care charges in your absence.