Online Forms

Complete your forms online.

Complete the necessary forms online prior to your next appointment. Please don’t hesitate to contact us with questions!

Click the toggles below to complete your form. If you’re submitting multiple forms, you must click submit after each completed form.

Payment Policy

Name *

First

Last

Email *

Phone *

Driver's License Number

Employer's Name & Address

Who may we contact, other than yourself, in case of an emergency with your pet? *

First

Last

Emergency Contact Phone *

Please list any persons other than yourself who have permission to consent to medical treatment for your animals:

All services MUST be paid for in full at the time of service, with NO EXCEPTIONS. This shall include routine health examinations, vaccinations, routine laboratory tests, surgeries, emergencies, perscription and non-prescription medicines, food and supplies. Payment may be made with Cash, Visa, MC, Discover, American Express and Care Credit. If payments are not received and the account becomes delinquent, the account will be subject to collections and/or legal action to enforce collection of money owed. If this becomes necessary, all expenses incurred in the collection of the debt including court costs and attorney's fee shall become the responsibility of the debtor in default. A service charge of $35.00 will apply in addition to the above, for any uncollected or returned checks. *

I have read the payment policy above, I agree to the terms and will follow the guidelines of the agreement and acknowledge that I am fully responsible for the charges incurred in the treatment of my animal.

I grant to Badger Veterinary Hospital, its representatives and employees, the right to take photographs of me /and or my pets, and to copyright, use , and publish the same in print and/or electronically. I agree that Badger Veterinary Hospital may use such photographs of me and/or my pets with or without my name and for any lawful purpose, including, for example, such purposes as publicity, illustration, advertising, and Web content. *

Yes
No

Signature *

Please type your name.

Phone

Dental Consent Form

Name *

First

Last

Email *

Phone *

Pet's Name *

Special Instructions

Extractions: Extractions will be done if needed under doctor discretion. *

I have read and understand

Payment: Payment is expected at the time services are rendered. The balance is due before your pet is released from the hospital. We realize that veterinary services may become necessary at times that are financially inconvenient; therefore, we accept cash, VISA, MasterCard, Discover, American Express and Care Credit credit cards. In order to keep our veterinary costs to a minimum, we cannot extend the privilege of charging services as this puts us in the position of becoming a lending institution. *

I have read and understand

Consent: I am the owner (or authorized agent for the owner) of the above named animal and have the authority to execute this consent. I hereby authorize the above procedures by the clinic veterinarians and staff which may include diagnostic, therapeutic, surgical or preventative procedures and to administer sedation and/or anesthesia as deemed necessary. Further, I understand why such procedures are necessary, their advantages, and possible complications. No guarantee of successful treatment is made or implied. *

I assume full responsibility for all charges incurred for this case and agree that payment of these charges will be made or arranged for before the animal is released.

Signature *

Email

Standard Consent Form

Name *

First

Last

Email *

Phone *

Pet's Name *

Special Instructions

Payment: Payment is expected at the time services are rendered. The balance is due before your pet is released from the hospital. We realize that veterinary services may become necessary at times that are financially inconvenient; therefore, we accept cash, VISA, MasterCard, Discover, American Express and Care Credit credit cards. In order to keep our veterinary costs to a minimum, we cannot extend the privilege of charging services as this puts us in the position of becoming a lending institution. *

I have read and understand.

Consent: I am the owner (or authorized agent for the owner) of the above named animal and have the authority to execute this consent. I hereby authorize the above procedures by the clinic veterinarians and staff which may include diagnostic, therapeutic, surgical or preventative procedures and to administer sedation and/or anesthesia as deemed necessary. Further, I understand why such procedures are necessary, their advantages, and possible complications. No guarantee of successful treatment is made or implied. *

I assume full responsibility for all charges incurred for this case and agree that payment of these charges will be made or arranged for before the animal is released.

Signature *

Message

Pre-Surgical and Post-Surgical Care Consent Form

Name *

First

Last

Email *

Phone *

Pet's Name *

Like you, our greatest concern is the well being of your pet. Your pet is scheduled for anesthesia and/or surgery. Before putting your pet under anesthesia, we will perform a full physical examination. However, we recommend a pre-anesthetic blood profile and ECG reading be performed in order that we may maximize patient safety and alert the doctor to the presence of dehydration, diabetes, kidney, liver disease or any heart abnormality which could complicate the procedure. These conditions may not be detected unless a pre-anesthetic testing is performed. These tests are similar to those your own physician would run were you to undergo anesthesia. In addition, the results of these tests may be useful later to develop faster, more accurate diagnoses and treatments in the event that your pet's health changes. Along with these pre-surgery recommendations, we also offer an recommend therapeutic laser treatments following surgery to aid in accelerated healing and pain management. State of the art equipment enables us to perform the pre-anesthetic blood profile and post-surgical laser treatment within the clinic and we are committed to making this technology available to your pet. Our ECG readings are electronically submitted to a cardiologist with results available within 30 minutes.

Please complete the blood work you recommended prior to anesthesia/surgery on my pet. If abnormalities are found, please contact me at the above number.
I have elected to refuse the recommended pre-anesthetic testing at this time and request that you proceed with anesthesia. I assume full financial responsibility for this/these animal(s). I understand there are always potential risks when using anesthesia or performing surgery on an animal.
Please complete the ECG screening recommended prior to anesthesia and/or surgery on my pet. If abnormalities are found, please contact me at this number.

Signature *

Phone

Drop Off Consent Form

Name *

First

Last

Email *

Phone *

Alternate Phone

Pet's Name *

Species *

Breed *

Age/DOB *

Sex *

Female
Spayed Female
Male
Neutered Male

Reason For Visit *

Please list any personal items that you are leaving with your pet:

I, the undersigned owner/authorized agent of the above listed patient, hereby authorized Badger Veterinary Hospital - Janesville and its staff to administer veterinary care to my animal. I understand that an estimate of the fees for veterinary services can be provided to me prior to service and that I am encouraged to discuss all fees related to such care before services are rendered. I agree to assume financial responsibility for the care provided here. All patients are discharged at the end of each business day; I realize that I am responsible for arranging pick up of my pet prior to the end of the business day. If emergency treatment is required and I cannot be reached, I authorize that life preserving action be taken for my pet until I can be contacted. I agree to assume full and complete financial responsibility for the balance of ALL services rendered (we accept cash, Visa, MC, Amex ,and Discover) at the time my pet is discharged. *

I have read and understand.

Signature *

Comment

Have a question?

We have multiple locations to make your life easier. If you have equine medical needs, we have a team for that, too! Please click below to contact one of our locations directly. You can also complete the forms below to ask general questions to our team!

We provide small animal, equine, boarding, and grooming services to the Southern Wisconsin community!

Multiple locations for your convenience!

Badger Veterinary Hospital-Janesville

3113 E. McCormick Dr.
Janesville, WI 53547
608.754.1888
janesville@badgervet.com

CONTACT

Badger Veterinary Hospital-Cambridge

712 Katie Ct.
Cambridge, WI 53523
608.423.3555
cambridge@badgervet.com

CONTACT

Badger Veterinary Hospital-Beloit

2889 Bartells Dr.
Beloit, WI 53511
608.362.1515
beloit@badgervet.com

CONTACT

Badger Equine Veterinary Services

712 Katie Court
Cambridge, WI 53523
608.754.1888
equine@badgervet.com

CONTACT

Badger Equine Veterinary Services

3113 E. McCormick Drive
Janesville, WI 53547
608.754.1888
equine@badgervet.com

CONTACT