<\/p>
Please take a few moments to fill out this brief information form so that our doctors can better evaluate your pet. Thank you!\n<\/p>\n
*<\/span>Client's Full Name:\n<\/span> <\/label>\n<\/p>\n *<\/span>Pet's Name:\n<\/span> <\/label>\n<\/p>\n*<\/span>Date of Scheduled Appointment:\n<\/span>\n<\/p>\n *<\/span>Time of Scheduled Appointment:\n<\/span> <\/label>\n<\/p>\n *<\/span>Reason for today's visit:\n<\/span> <\/label>\n<\/p>\n *<\/span>Best phone number to reach you today:\n<\/span> <\/label>\n<\/p>\n *<\/span>Please elaborate on any symptoms below that your pet is exhibiting.\n<\/textarea><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Appetite:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"appetite\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"appetite\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"appetite\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"appetite\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-1\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-1\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Water Intake:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"water-intake\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"water-intake\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"water-intake\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"water-intake\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-2\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-2\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Urination:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"urination\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"urination\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"urination\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"urination\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-3\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-3\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Straining to pass stool or urine?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"straining-pass-stool\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"straining-pass-stool\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"straining-pass-stool\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-4\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-4\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Vomiting?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"vomiting\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"vomiting\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"vomiting\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-5\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-5\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Coughing?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"coughing\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"coughing\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"coughing\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-6\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-6\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Sneezing?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"sneezing\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"sneezing\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"sneezing\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-7\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-7\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Shaking head\/scratching at ears?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"shaking-scratching\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"shaking-scratching\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"shaking-scratching\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-8\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-8\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Any new bumps\/lumps\/scabs\/sores?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"new-bumps\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"new-bumps\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"new-bumps\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, where and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-9\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-9\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Lethargic?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lethargic\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"lethargic\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"lethargic\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, when did this begin?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lethargic-begin\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"lethargic-begin\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Limping?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"limping\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"limping\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"limping\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, please tell us which leg\/paw (front, back, left, right) and when it started:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"limping-started\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"limping-started\" \/><\/span> <\/label>\n<\/p>\n<p><label> Any other symptoms not listed above?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"symptoms-not-listed\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"symptoms-not-listed\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Do you give your pet monthly heartworm prevention?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"monthly-heartworm\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"monthly-heartworm\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"monthly-heartworm\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, have you missed any doses? Which product do you use?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"missed-dose-product\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"missed-dose-product\" \/><\/span> <\/label>\n<\/p>\n<p>Date of last application:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-1\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"last-application-1\" \/><\/span>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Do you keep your pet on monthly flea and tick prevention?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"flea-tick\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"flea-tick\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"flea-tick\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, when was the last application? Which product do you use?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-1\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"last-application-1\" \/><\/span> <\/label>\n<\/p>\n<p>Date of last Application:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-2\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"last-application-2\" \/><\/span>\n<\/p>\n<p><label> <span style=\"color: #ff0000;\">*<\/span>What is your pet's diet (type, brand, daily amount)?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"diet\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"diet\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Is your pet on any other medications (please list names and doses)?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other-medications\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other-medications\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Please elaborate on symptoms or list other details that the doctor should know about your pet.<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other-symptoms\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other-symptoms\"><\/textarea><\/span> <\/label>\n<\/p>\n<p>Professional fees are to be paid at the time services are performed.\n<\/p>\n<p>In admitting my pet(s) for diagnostics, treatment, or surgery, I authorize the veterinarians of Beckett & Associates Veterinary Services, LLC and their support staff, to administer such treatment and\/or perform such diagnostic or surgical procedures as deeemed.\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Date:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date\" \/><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n<\/p><div class=\"fusion-alert alert custom alert-custom fusion-alert-center wpcf7-response-output awb-alert-native-link-color alert-dismissable awb-alert-close-boxed\" style=\"--awb-border-size:1px;--awb-border-top-left-radius:0px;--awb-border-top-right-radius:0px;--awb-border-bottom-left-radius:0px;--awb-border-bottom-right-radius:0px;\" role=\"alert\"><div class=\"fusion-alert-content-wrapper\"><span class=\"fusion-alert-content\"><\/span><\/div><button type=\"button\" class=\"close toggle-alert\" data-dismiss=\"alert\" aria-label=\"Close\">×<\/button><\/div>\n<\/form>\n<\/div>\n<\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 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class=\"fusion-button-text\">Request an Appointment<\/span><\/a><\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-178","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/comments?post=178"}],"version-history":[{"count":33,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178\/revisions"}],"predecessor-version":[{"id":1620,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178\/revisions\/1620"}],"wp:attachment":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/media?parent=178"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
*<\/span>Pet's Name:\n<\/span> <\/label>\n<\/p>\n*<\/span>Date of Scheduled Appointment:\n<\/span>\n<\/p>\n *<\/span>Time of Scheduled Appointment:\n<\/span> <\/label>\n<\/p>\n *<\/span>Reason for today's visit:\n<\/span> <\/label>\n<\/p>\n *<\/span>Best phone number to reach you today:\n<\/span> <\/label>\n<\/p>\n *<\/span>Please elaborate on any symptoms below that your pet is exhibiting.\n<\/textarea><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Appetite:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"appetite\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"appetite\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"appetite\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"appetite\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-1\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-1\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Water Intake:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"water-intake\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"water-intake\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"water-intake\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"water-intake\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-2\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-2\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Urination:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"urination\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"urination\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"urination\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"urination\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-3\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-3\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Straining to pass stool or urine?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"straining-pass-stool\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"straining-pass-stool\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"straining-pass-stool\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-4\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-4\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Vomiting?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"vomiting\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"vomiting\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"vomiting\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-5\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-5\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Coughing?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"coughing\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"coughing\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"coughing\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-6\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-6\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Sneezing?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"sneezing\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"sneezing\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"sneezing\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-7\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-7\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Shaking head\/scratching at ears?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"shaking-scratching\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"shaking-scratching\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"shaking-scratching\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-8\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-8\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Any new bumps\/lumps\/scabs\/sores?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"new-bumps\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"new-bumps\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"new-bumps\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, where and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-9\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-9\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Lethargic?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lethargic\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"lethargic\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"lethargic\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, when did this begin?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lethargic-begin\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"lethargic-begin\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Limping?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"limping\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"limping\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"limping\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, please tell us which leg\/paw (front, back, left, right) and when it started:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"limping-started\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"limping-started\" \/><\/span> <\/label>\n<\/p>\n<p><label> Any other symptoms not listed above?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"symptoms-not-listed\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"symptoms-not-listed\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Do you give your pet monthly heartworm prevention?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"monthly-heartworm\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"monthly-heartworm\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"monthly-heartworm\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, have you missed any doses? Which product do you use?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"missed-dose-product\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"missed-dose-product\" \/><\/span> <\/label>\n<\/p>\n<p>Date of last application:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-1\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"last-application-1\" \/><\/span>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Do you keep your pet on monthly flea and tick prevention?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"flea-tick\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"flea-tick\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"flea-tick\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, when was the last application? Which product do you use?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-1\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"last-application-1\" \/><\/span> <\/label>\n<\/p>\n<p>Date of last Application:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-2\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"last-application-2\" \/><\/span>\n<\/p>\n<p><label> <span style=\"color: #ff0000;\">*<\/span>What is your pet's diet (type, brand, daily amount)?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"diet\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"diet\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Is your pet on any other medications (please list names and doses)?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other-medications\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other-medications\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Please elaborate on symptoms or list other details that the doctor should know about your pet.<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other-symptoms\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other-symptoms\"><\/textarea><\/span> <\/label>\n<\/p>\n<p>Professional fees are to be paid at the time services are performed.\n<\/p>\n<p>In admitting my pet(s) for diagnostics, treatment, or surgery, I authorize the veterinarians of Beckett & Associates Veterinary Services, LLC and their support staff, to administer such treatment and\/or perform such diagnostic or surgical procedures as deeemed.\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Date:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date\" \/><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n<\/p><div class=\"fusion-alert alert custom alert-custom fusion-alert-center wpcf7-response-output awb-alert-native-link-color alert-dismissable awb-alert-close-boxed\" style=\"--awb-border-size:1px;--awb-border-top-left-radius:0px;--awb-border-top-right-radius:0px;--awb-border-bottom-left-radius:0px;--awb-border-bottom-right-radius:0px;\" role=\"alert\"><div class=\"fusion-alert-content-wrapper\"><span class=\"fusion-alert-content\"><\/span><\/div><button type=\"button\" class=\"close toggle-alert\" data-dismiss=\"alert\" aria-label=\"Close\">×<\/button><\/div>\n<\/form>\n<\/div>\n<\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 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class=\"fusion-button-text\">Request an Appointment<\/span><\/a><\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-178","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/comments?post=178"}],"version-history":[{"count":33,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178\/revisions"}],"predecessor-version":[{"id":1620,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178\/revisions\/1620"}],"wp:attachment":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/media?parent=178"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
*<\/span>Date of Scheduled Appointment:\n<\/span>\n<\/p>\n *<\/span>Time of Scheduled Appointment:\n<\/span> <\/label>\n<\/p>\n *<\/span>Reason for today's visit:\n<\/span> <\/label>\n<\/p>\n *<\/span>Best phone number to reach you today:\n<\/span> <\/label>\n<\/p>\n *<\/span>Please elaborate on any symptoms below that your pet is exhibiting.\n<\/textarea><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Appetite:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"appetite\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"appetite\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"appetite\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"appetite\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-1\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-1\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Water Intake:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"water-intake\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"water-intake\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"water-intake\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"water-intake\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-2\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-2\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Urination:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"urination\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"urination\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"urination\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"urination\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-3\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-3\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Straining to pass stool or urine?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"straining-pass-stool\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"straining-pass-stool\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"straining-pass-stool\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-4\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-4\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Vomiting?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"vomiting\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"vomiting\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"vomiting\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-5\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-5\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Coughing?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"coughing\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"coughing\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"coughing\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-6\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-6\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Sneezing?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"sneezing\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"sneezing\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"sneezing\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-7\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-7\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Shaking head\/scratching at ears?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"shaking-scratching\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"shaking-scratching\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"shaking-scratching\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-8\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-8\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Any new bumps\/lumps\/scabs\/sores?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"new-bumps\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"new-bumps\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"new-bumps\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, where and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-9\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-9\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Lethargic?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lethargic\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"lethargic\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"lethargic\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, when did this begin?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lethargic-begin\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"lethargic-begin\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Limping?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"limping\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"limping\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"limping\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, please tell us which leg\/paw (front, back, left, right) and when it started:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"limping-started\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"limping-started\" \/><\/span> <\/label>\n<\/p>\n<p><label> Any other symptoms not listed above?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"symptoms-not-listed\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"symptoms-not-listed\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Do you give your pet monthly heartworm prevention?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"monthly-heartworm\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"monthly-heartworm\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"monthly-heartworm\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, have you missed any doses? Which product do you use?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"missed-dose-product\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"missed-dose-product\" \/><\/span> <\/label>\n<\/p>\n<p>Date of last application:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-1\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"last-application-1\" \/><\/span>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Do you keep your pet on monthly flea and tick prevention?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"flea-tick\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"flea-tick\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"flea-tick\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, when was the last application? Which product do you use?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-1\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"last-application-1\" \/><\/span> <\/label>\n<\/p>\n<p>Date of last Application:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-2\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"last-application-2\" \/><\/span>\n<\/p>\n<p><label> <span style=\"color: #ff0000;\">*<\/span>What is your pet's diet (type, brand, daily amount)?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"diet\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"diet\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Is your pet on any other medications (please list names and doses)?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other-medications\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other-medications\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Please elaborate on symptoms or list other details that the doctor should know about your pet.<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other-symptoms\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other-symptoms\"><\/textarea><\/span> <\/label>\n<\/p>\n<p>Professional fees are to be paid at the time services are performed.\n<\/p>\n<p>In admitting my pet(s) for diagnostics, treatment, or surgery, I authorize the veterinarians of Beckett & Associates Veterinary Services, LLC and their support staff, to administer such treatment and\/or perform such diagnostic or surgical procedures as deeemed.\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Date:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date\" \/><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n<\/p><div class=\"fusion-alert alert custom alert-custom fusion-alert-center wpcf7-response-output awb-alert-native-link-color alert-dismissable awb-alert-close-boxed\" style=\"--awb-border-size:1px;--awb-border-top-left-radius:0px;--awb-border-top-right-radius:0px;--awb-border-bottom-left-radius:0px;--awb-border-bottom-right-radius:0px;\" role=\"alert\"><div class=\"fusion-alert-content-wrapper\"><span class=\"fusion-alert-content\"><\/span><\/div><button type=\"button\" class=\"close toggle-alert\" data-dismiss=\"alert\" aria-label=\"Close\">×<\/button><\/div>\n<\/form>\n<\/div>\n<\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 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class=\"title-sep-container title-sep-container-left\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#673d41;\"><\/div><\/div><span class=\"awb-title-spacer\"><\/span><h2 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\"><em>Professional care for your pets, horses & farm animals<\/em><\/h2><span class=\"awb-title-spacer\"><\/span><div class=\"title-sep-container title-sep-container-right\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#673d41;\"><\/div><\/div><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat button-xlarge button-default fusion-button-default button-2 fusion-button-default-span fusion-button-default-type fusion-animated\" data-animationType=\"fadeIn\" data-animationDuration=\"1.0\" data-animationOffset=\"top-into-view\" target=\"_blank\" rel=\"noopener noreferrer\" href=\"https:\/\/olsr2.covetrus.com\/?AID=HtpiO5253D8w1ZJ88WXEh&cl=1&location=1&scrollToAppts\"><span class=\"fusion-button-text\">Request an Appointment<\/span><\/a><\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-178","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/comments?post=178"}],"version-history":[{"count":33,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178\/revisions"}],"predecessor-version":[{"id":1620,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178\/revisions\/1620"}],"wp:attachment":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/media?parent=178"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
*<\/span>Time of Scheduled Appointment:\n<\/span> <\/label>\n<\/p>\n *<\/span>Reason for today's visit:\n<\/span> <\/label>\n<\/p>\n *<\/span>Best phone number to reach you today:\n<\/span> <\/label>\n<\/p>\n *<\/span>Please elaborate on any symptoms below that your pet is exhibiting.\n<\/textarea><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Appetite:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"appetite\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"appetite\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"appetite\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"appetite\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-1\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-1\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Water Intake:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"water-intake\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"water-intake\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"water-intake\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"water-intake\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-2\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-2\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Urination:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"urination\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"urination\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"urination\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"urination\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-3\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-3\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Straining to pass stool or urine?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"straining-pass-stool\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"straining-pass-stool\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"straining-pass-stool\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-4\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-4\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Vomiting?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"vomiting\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"vomiting\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"vomiting\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-5\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-5\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Coughing?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"coughing\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"coughing\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"coughing\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-6\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-6\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Sneezing?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"sneezing\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"sneezing\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"sneezing\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-7\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-7\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Shaking head\/scratching at ears?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"shaking-scratching\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"shaking-scratching\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"shaking-scratching\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-8\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-8\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Any new bumps\/lumps\/scabs\/sores?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"new-bumps\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"new-bumps\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"new-bumps\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, where and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-9\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-9\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Lethargic?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lethargic\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"lethargic\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"lethargic\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, when did this begin?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lethargic-begin\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"lethargic-begin\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Limping?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"limping\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"limping\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"limping\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, please tell us which leg\/paw (front, back, left, right) and when it started:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"limping-started\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"limping-started\" \/><\/span> <\/label>\n<\/p>\n<p><label> Any other symptoms not listed above?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"symptoms-not-listed\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"symptoms-not-listed\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Do you give your pet monthly heartworm prevention?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"monthly-heartworm\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"monthly-heartworm\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"monthly-heartworm\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, have you missed any doses? Which product do you use?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"missed-dose-product\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"missed-dose-product\" \/><\/span> <\/label>\n<\/p>\n<p>Date of last application:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-1\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"last-application-1\" \/><\/span>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Do you keep your pet on monthly flea and tick prevention?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"flea-tick\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"flea-tick\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"flea-tick\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, when was the last application? Which product do you use?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-1\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"last-application-1\" \/><\/span> <\/label>\n<\/p>\n<p>Date of last Application:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-2\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"last-application-2\" \/><\/span>\n<\/p>\n<p><label> <span style=\"color: #ff0000;\">*<\/span>What is your pet's diet (type, brand, daily amount)?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"diet\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"diet\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Is your pet on any other medications (please list names and doses)?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other-medications\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other-medications\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Please elaborate on symptoms or list other details that the doctor should know about your pet.<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other-symptoms\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other-symptoms\"><\/textarea><\/span> <\/label>\n<\/p>\n<p>Professional fees are to be paid at the time services are performed.\n<\/p>\n<p>In admitting my pet(s) for diagnostics, treatment, or surgery, I authorize the veterinarians of Beckett & Associates Veterinary Services, LLC and their support staff, to administer such treatment and\/or perform such diagnostic or surgical procedures as deeemed.\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Date:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date\" \/><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n<\/p><div class=\"fusion-alert alert custom alert-custom fusion-alert-center wpcf7-response-output awb-alert-native-link-color alert-dismissable awb-alert-close-boxed\" style=\"--awb-border-size:1px;--awb-border-top-left-radius:0px;--awb-border-top-right-radius:0px;--awb-border-bottom-left-radius:0px;--awb-border-bottom-right-radius:0px;\" role=\"alert\"><div class=\"fusion-alert-content-wrapper\"><span class=\"fusion-alert-content\"><\/span><\/div><button type=\"button\" class=\"close toggle-alert\" data-dismiss=\"alert\" aria-label=\"Close\">×<\/button><\/div>\n<\/form>\n<\/div>\n<\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 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class=\"title-sep-container title-sep-container-left\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#673d41;\"><\/div><\/div><span class=\"awb-title-spacer\"><\/span><h2 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\"><em>Professional care for your pets, horses & farm animals<\/em><\/h2><span class=\"awb-title-spacer\"><\/span><div class=\"title-sep-container title-sep-container-right\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#673d41;\"><\/div><\/div><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat button-xlarge button-default fusion-button-default button-2 fusion-button-default-span fusion-button-default-type fusion-animated\" data-animationType=\"fadeIn\" data-animationDuration=\"1.0\" data-animationOffset=\"top-into-view\" target=\"_blank\" rel=\"noopener noreferrer\" href=\"https:\/\/olsr2.covetrus.com\/?AID=HtpiO5253D8w1ZJ88WXEh&cl=1&location=1&scrollToAppts\"><span class=\"fusion-button-text\">Request an Appointment<\/span><\/a><\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-178","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/comments?post=178"}],"version-history":[{"count":33,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178\/revisions"}],"predecessor-version":[{"id":1620,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178\/revisions\/1620"}],"wp:attachment":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/media?parent=178"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
*<\/span>Reason for today's visit:\n<\/span> <\/label>\n<\/p>\n *<\/span>Best phone number to reach you today:\n<\/span> <\/label>\n<\/p>\n *<\/span>Please elaborate on any symptoms below that your pet is exhibiting.\n<\/textarea><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Appetite:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"appetite\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"appetite\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"appetite\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"appetite\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-1\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-1\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Water Intake:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"water-intake\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"water-intake\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"water-intake\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"water-intake\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-2\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-2\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Urination:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"urination\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"urination\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"urination\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"urination\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-3\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-3\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Straining to pass stool or urine?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"straining-pass-stool\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"straining-pass-stool\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"straining-pass-stool\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-4\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-4\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Vomiting?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"vomiting\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"vomiting\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"vomiting\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-5\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-5\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Coughing?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"coughing\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"coughing\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"coughing\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-6\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-6\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Sneezing?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"sneezing\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"sneezing\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"sneezing\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-7\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-7\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Shaking head\/scratching at ears?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"shaking-scratching\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"shaking-scratching\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"shaking-scratching\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-8\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-8\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Any new bumps\/lumps\/scabs\/sores?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"new-bumps\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"new-bumps\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"new-bumps\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, where and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-9\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-9\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Lethargic?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lethargic\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"lethargic\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"lethargic\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, when did this begin?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lethargic-begin\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"lethargic-begin\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Limping?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"limping\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"limping\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"limping\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, please tell us which leg\/paw (front, back, left, right) and when it started:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"limping-started\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"limping-started\" \/><\/span> <\/label>\n<\/p>\n<p><label> Any other symptoms not listed above?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"symptoms-not-listed\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"symptoms-not-listed\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Do you give your pet monthly heartworm prevention?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"monthly-heartworm\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"monthly-heartworm\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"monthly-heartworm\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, have you missed any doses? Which product do you use?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"missed-dose-product\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"missed-dose-product\" \/><\/span> <\/label>\n<\/p>\n<p>Date of last application:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-1\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"last-application-1\" \/><\/span>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Do you keep your pet on monthly flea and tick prevention?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"flea-tick\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"flea-tick\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"flea-tick\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, when was the last application? Which product do you use?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-1\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"last-application-1\" \/><\/span> <\/label>\n<\/p>\n<p>Date of last Application:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-2\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"last-application-2\" \/><\/span>\n<\/p>\n<p><label> <span style=\"color: #ff0000;\">*<\/span>What is your pet's diet (type, brand, daily amount)?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"diet\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"diet\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Is your pet on any other medications (please list names and doses)?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other-medications\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other-medications\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Please elaborate on symptoms or list other details that the doctor should know about your pet.<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other-symptoms\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other-symptoms\"><\/textarea><\/span> <\/label>\n<\/p>\n<p>Professional fees are to be paid at the time services are performed.\n<\/p>\n<p>In admitting my pet(s) for diagnostics, treatment, or surgery, I authorize the veterinarians of Beckett & Associates Veterinary Services, LLC and their support staff, to administer such treatment and\/or perform such diagnostic or surgical procedures as deeemed.\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Date:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date\" \/><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n<\/p><div class=\"fusion-alert alert custom alert-custom fusion-alert-center wpcf7-response-output awb-alert-native-link-color alert-dismissable awb-alert-close-boxed\" style=\"--awb-border-size:1px;--awb-border-top-left-radius:0px;--awb-border-top-right-radius:0px;--awb-border-bottom-left-radius:0px;--awb-border-bottom-right-radius:0px;\" role=\"alert\"><div class=\"fusion-alert-content-wrapper\"><span class=\"fusion-alert-content\"><\/span><\/div><button type=\"button\" class=\"close toggle-alert\" data-dismiss=\"alert\" aria-label=\"Close\">×<\/button><\/div>\n<\/form>\n<\/div>\n<\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_6 1_6 fusion-flex-column fusion-animated\" style=\"--awb-bg-size:cover;--awb-width-large:16.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:11.52%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:11.52%;--awb-width-medium:16.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:11.52%;--awb-spacing-left-medium:11.52%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-animationType=\"fadeIn\" data-animationDuration=\"1.0\" data-animationOffset=\"top-into-view\" 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class=\"title-sep-container title-sep-container-left\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#673d41;\"><\/div><\/div><span class=\"awb-title-spacer\"><\/span><h2 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\"><em>Professional care for your pets, horses & farm animals<\/em><\/h2><span class=\"awb-title-spacer\"><\/span><div class=\"title-sep-container title-sep-container-right\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#673d41;\"><\/div><\/div><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat button-xlarge button-default fusion-button-default button-2 fusion-button-default-span fusion-button-default-type fusion-animated\" data-animationType=\"fadeIn\" data-animationDuration=\"1.0\" data-animationOffset=\"top-into-view\" target=\"_blank\" rel=\"noopener noreferrer\" href=\"https:\/\/olsr2.covetrus.com\/?AID=HtpiO5253D8w1ZJ88WXEh&cl=1&location=1&scrollToAppts\"><span class=\"fusion-button-text\">Request an Appointment<\/span><\/a><\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-178","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/comments?post=178"}],"version-history":[{"count":33,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178\/revisions"}],"predecessor-version":[{"id":1620,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178\/revisions\/1620"}],"wp:attachment":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/media?parent=178"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
*<\/span>Best phone number to reach you today:\n<\/span> <\/label>\n<\/p>\n *<\/span>Please elaborate on any symptoms below that your pet is exhibiting.\n<\/textarea><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Appetite:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"appetite\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"appetite\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"appetite\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"appetite\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-1\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-1\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Water Intake:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"water-intake\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"water-intake\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"water-intake\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"water-intake\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-2\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-2\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Urination:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"urination\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"urination\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"urination\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"urination\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-3\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-3\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Straining to pass stool or urine?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"straining-pass-stool\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"straining-pass-stool\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"straining-pass-stool\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-4\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-4\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Vomiting?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"vomiting\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"vomiting\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"vomiting\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-5\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-5\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Coughing?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"coughing\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"coughing\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"coughing\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-6\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-6\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Sneezing?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"sneezing\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"sneezing\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"sneezing\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-7\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-7\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Shaking head\/scratching at ears?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"shaking-scratching\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"shaking-scratching\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"shaking-scratching\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-8\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-8\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Any new bumps\/lumps\/scabs\/sores?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"new-bumps\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"new-bumps\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"new-bumps\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, where and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-9\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-9\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Lethargic?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lethargic\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"lethargic\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"lethargic\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, when did this begin?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lethargic-begin\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"lethargic-begin\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Limping?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"limping\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"limping\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"limping\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, please tell us which leg\/paw (front, back, left, right) and when it started:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"limping-started\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"limping-started\" \/><\/span> <\/label>\n<\/p>\n<p><label> Any other symptoms not listed above?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"symptoms-not-listed\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"symptoms-not-listed\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Do you give your pet monthly heartworm prevention?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"monthly-heartworm\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"monthly-heartworm\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"monthly-heartworm\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, have you missed any doses? Which product do you use?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"missed-dose-product\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"missed-dose-product\" \/><\/span> <\/label>\n<\/p>\n<p>Date of last application:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-1\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"last-application-1\" \/><\/span>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Do you keep your pet on monthly flea and tick prevention?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"flea-tick\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"flea-tick\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"flea-tick\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, when was the last application? Which product do you use?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-1\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"last-application-1\" \/><\/span> <\/label>\n<\/p>\n<p>Date of last Application:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-2\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"last-application-2\" \/><\/span>\n<\/p>\n<p><label> <span style=\"color: #ff0000;\">*<\/span>What is your pet's diet (type, brand, daily amount)?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"diet\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"diet\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Is your pet on any other medications (please list names and doses)?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other-medications\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other-medications\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Please elaborate on symptoms or list other details that the doctor should know about your pet.<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other-symptoms\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other-symptoms\"><\/textarea><\/span> <\/label>\n<\/p>\n<p>Professional fees are to be paid at the time services are performed.\n<\/p>\n<p>In admitting my pet(s) for diagnostics, treatment, or surgery, I authorize the veterinarians of Beckett & Associates Veterinary Services, LLC and their support staff, to administer such treatment and\/or perform such diagnostic or surgical procedures as deeemed.\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Date:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date\" \/><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n<\/p><div class=\"fusion-alert alert custom alert-custom fusion-alert-center wpcf7-response-output awb-alert-native-link-color alert-dismissable awb-alert-close-boxed\" style=\"--awb-border-size:1px;--awb-border-top-left-radius:0px;--awb-border-top-right-radius:0px;--awb-border-bottom-left-radius:0px;--awb-border-bottom-right-radius:0px;\" role=\"alert\"><div class=\"fusion-alert-content-wrapper\"><span class=\"fusion-alert-content\"><\/span><\/div><button type=\"button\" class=\"close toggle-alert\" data-dismiss=\"alert\" aria-label=\"Close\">×<\/button><\/div>\n<\/form>\n<\/div>\n<\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_6 1_6 fusion-flex-column fusion-animated\" style=\"--awb-bg-size:cover;--awb-width-large:16.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:11.52%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:11.52%;--awb-width-medium:16.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:11.52%;--awb-spacing-left-medium:11.52%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-animationType=\"fadeIn\" data-animationDuration=\"1.0\" data-animationOffset=\"top-into-view\" 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class=\"title-sep-container title-sep-container-left\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#673d41;\"><\/div><\/div><span class=\"awb-title-spacer\"><\/span><h2 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\"><em>Professional care for your pets, horses & farm animals<\/em><\/h2><span class=\"awb-title-spacer\"><\/span><div class=\"title-sep-container title-sep-container-right\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#673d41;\"><\/div><\/div><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat button-xlarge button-default fusion-button-default button-2 fusion-button-default-span fusion-button-default-type fusion-animated\" data-animationType=\"fadeIn\" data-animationDuration=\"1.0\" data-animationOffset=\"top-into-view\" target=\"_blank\" rel=\"noopener noreferrer\" href=\"https:\/\/olsr2.covetrus.com\/?AID=HtpiO5253D8w1ZJ88WXEh&cl=1&location=1&scrollToAppts\"><span class=\"fusion-button-text\">Request an Appointment<\/span><\/a><\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-178","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/comments?post=178"}],"version-history":[{"count":33,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178\/revisions"}],"predecessor-version":[{"id":1620,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178\/revisions\/1620"}],"wp:attachment":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/media?parent=178"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
*<\/span>Please elaborate on any symptoms below that your pet is exhibiting.\n<\/textarea><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Appetite:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"appetite\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"appetite\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"appetite\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"appetite\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-1\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-1\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Water Intake:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"water-intake\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"water-intake\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"water-intake\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"water-intake\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-2\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-2\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Urination:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"urination\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"urination\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"urination\" value=\"Decreased\" \/><span class=\"wpcf7-list-item-label\">Decreased<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"urination\" value=\"Increased\" \/><span class=\"wpcf7-list-item-label\">Increased<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If increased or decreased, when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-3\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-3\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Straining to pass stool or urine?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"straining-pass-stool\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"straining-pass-stool\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"straining-pass-stool\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-4\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-4\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Vomiting?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"vomiting\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"vomiting\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"vomiting\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-5\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-5\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Coughing?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"coughing\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"coughing\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"coughing\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-6\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-6\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Sneezing?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"sneezing\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"sneezing\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"sneezing\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-7\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-7\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Shaking head\/scratching at ears?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"shaking-scratching\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"shaking-scratching\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"shaking-scratching\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, for how long and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-8\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-8\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Any new bumps\/lumps\/scabs\/sores?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"new-bumps\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"new-bumps\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"new-bumps\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, where and when did you first notice?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-notice-9\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-notice-9\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Lethargic?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lethargic\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"lethargic\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"lethargic\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, when did this begin?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lethargic-begin\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"lethargic-begin\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Limping?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"limping\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"limping\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"limping\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, please tell us which leg\/paw (front, back, left, right) and when it started:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"limping-started\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"limping-started\" \/><\/span> <\/label>\n<\/p>\n<p><label> Any other symptoms not listed above?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"symptoms-not-listed\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"symptoms-not-listed\" \/><\/span> <\/label>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Do you give your pet monthly heartworm prevention?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"monthly-heartworm\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"monthly-heartworm\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"monthly-heartworm\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, have you missed any doses? Which product do you use?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"missed-dose-product\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"missed-dose-product\" \/><\/span> <\/label>\n<\/p>\n<p>Date of last application:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-1\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"last-application-1\" \/><\/span>\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Do you keep your pet on monthly flea and tick prevention?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"flea-tick\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"flea-tick\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"flea-tick\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> If yes, when was the last application? Which product do you use?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-1\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"last-application-1\" \/><\/span> <\/label>\n<\/p>\n<p>Date of last Application:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-application-2\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"last-application-2\" \/><\/span>\n<\/p>\n<p><label> <span style=\"color: #ff0000;\">*<\/span>What is your pet's diet (type, brand, daily amount)?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"diet\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"diet\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Is your pet on any other medications (please list names and doses)?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other-medications\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other-medications\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Please elaborate on symptoms or list other details that the doctor should know about your pet.<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other-symptoms\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other-symptoms\"><\/textarea><\/span> <\/label>\n<\/p>\n<p>Professional fees are to be paid at the time services are performed.\n<\/p>\n<p>In admitting my pet(s) for diagnostics, treatment, or surgery, I authorize the veterinarians of Beckett & Associates Veterinary Services, LLC and their support staff, to administer such treatment and\/or perform such diagnostic or surgical procedures as deeemed.\n<\/p>\n<p><span style=\"color: #ff0000;\">*<\/span>Date:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date\" \/><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n<\/p><div class=\"fusion-alert alert custom alert-custom fusion-alert-center wpcf7-response-output awb-alert-native-link-color alert-dismissable awb-alert-close-boxed\" style=\"--awb-border-size:1px;--awb-border-top-left-radius:0px;--awb-border-top-right-radius:0px;--awb-border-bottom-left-radius:0px;--awb-border-bottom-right-radius:0px;\" role=\"alert\"><div class=\"fusion-alert-content-wrapper\"><span class=\"fusion-alert-content\"><\/span><\/div><button type=\"button\" class=\"close toggle-alert\" data-dismiss=\"alert\" aria-label=\"Close\">×<\/button><\/div>\n<\/form>\n<\/div>\n<\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 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class=\"title-sep-container title-sep-container-left\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#673d41;\"><\/div><\/div><span class=\"awb-title-spacer\"><\/span><h2 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\"><em>Professional care for your pets, horses & farm animals<\/em><\/h2><span class=\"awb-title-spacer\"><\/span><div class=\"title-sep-container title-sep-container-right\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#673d41;\"><\/div><\/div><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat button-xlarge button-default fusion-button-default button-2 fusion-button-default-span fusion-button-default-type fusion-animated\" data-animationType=\"fadeIn\" data-animationDuration=\"1.0\" data-animationOffset=\"top-into-view\" target=\"_blank\" rel=\"noopener noreferrer\" href=\"https:\/\/olsr2.covetrus.com\/?AID=HtpiO5253D8w1ZJ88WXEh&cl=1&location=1&scrollToAppts\"><span class=\"fusion-button-text\">Request an Appointment<\/span><\/a><\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-178","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/comments?post=178"}],"version-history":[{"count":33,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178\/revisions"}],"predecessor-version":[{"id":1620,"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/pages\/178\/revisions\/1620"}],"wp:attachment":[{"href":"https:\/\/beta.simplydonetech6.com\/beckettvet-beta\/wp-json\/wp\/v2\/media?parent=178"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}