Forms & Requests

Appointment Request Form

Appointment Request Form

We frequently check email and faxes, and our front desk staff will be in touch promptly. However, please allow one business day to respond in setting up your appointment. Same day appointments are best scheduled by calling the office directly at 317-336-8900.

Pet Type:
Nature of Issue for Appointment
Desired Time

Prescription Refill Form

Prescription Refill Form
Please note that this form can be used to dispense medication precribed by our office. Please allow one buiness day for processing.
Desired Time of Pickup?

Behavioral Questionnaire

Behavioral Questionnaire
Where did you get this pet? (select all that apply) *
What is the primary purpose for getting this pet? (select all that apply)
Is your weekday schedule consistent?
Where is the pet when he/she is left alone? (select all that apply)
What kind of living situation do you have?
Where is your pet at night? (select all that apply)
How many times is your dog or cat let outside per day?
How many meals does your pet get each day?
How often is your pet fed treats (cat treats, dog biscuits, chews) each day?
How often do you feed your pet snacks from the table (i.e. human food) each day?
Has your household had any significant changes since adopting this pet? If so, how? (select all that apply)
Have you had dogs before?
Have you had a cat before?
How often do you play with toys or play games with your pet indoors on a daily basis?
How often do you play with toys or play games with your pet outdoors on a daily basis?
How would you describe your pet's personality? (select all that apply)
Does your DOG regularly (at least weekly) engage in the following:
When owner is present
When owner is absent
Excessive barking/whining
House soiling
Destructive chewing
Self licking/chewing
Pacing, repetitive behavior
(Cats only) How many litter boxes do you have?
(Cats only) What kind of litter material do you put in the litter box(es)? (select all that apply)
(Dogs only) Do you use the following training aids? (select all that apply)

Feline Inappropriate Urination Questionnaire

Feline Inappropriate Urination Questionnaire
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