18577 Natchez Avenue
Prior Lake, Minnesota, 55372

Phone: 952-435-8387

Fax: 952-435-8777

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Check-In Form

  • Authorization to Provide Care

  • 1. I am the owner (or authorized agent of the owner of) my Pet. I hereby authorize Cleary Lake Veterinary Hospital, its veterinarians, technicians, and assistants to perform services, procedures, diagnostics, vaccinations, treatments, and administration of extra label medications as deemed necessary or advisable in connection with his/her comprehensive exam.

    2. I understand that there is a risk of complications with every procedure. I also understand that there is no guarantee as to the results of any procedures, diagnostics, vaccinations, or treatments. I understand that I may ask any questions that I have regarding any procedure, diagnostic, vaccination, or treatment recommended by the veterinarian before it is performed.

    3. I understand that payment is due in full at the time services are rendered. Please complete and sign below.

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