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Owner / Caregiver

Please provide the information below as completely as possible. All information is strictly confidential.

Pet Information

Referral Information

Statement Of Ownership

By checking below you certify that you are the owner and or agent of the above animal and have the authorization to consent to treatment if and when it is needed.

General Medical History

History of Current Problem

Authorization: I hereby authorize Peak Performance Veterinary Group to examine, prescribe for, and treat the above-mentioned pet. I assume all charges incurred in the care of the animal. ALL PROFESSIONAL FEES ARE DUE AT THE TIME SERVICES ARE RENDERED. I consent to release all medical information to and from my regular daytime veterinarian.

Cancellation and No-Show Policy: We excel in quality care by scheduling the appropriate amount of treatment time for each patient. Your appointment is a specific time that we set aside especially for you and your companion, so it is extremely important to be timely. If you are unable to keep your appointment, YOU MUST NOTIFY THE OFFICE 48 HOURS IN ADVANCE. You will be charged a normal appointment fee for no-shows, and you may be charged a missed appointment fee for tardiness of 10 minutes or more. You will be asked to reschedule your appointment if you are 10 minutes late. Thank you for your consideration and assistance.

Office use only:

T ________ P ________ R ________ W ________ PPOP ______ PH ______ QOL ______ STR ______ RTY ______ CTY _____

Exclusive Offer

THIS ---->https://peakvetscom.vetmatrixbase.com/pet-owners/new-patient-center/online-forms/new-pet-intake-form.html

Office Hours

DayMorningAfternoon
MondayClosed closed
Tuesday9-121-5
WednesdayClosedClosed
Thursday9-121-5
FridayClosedClosed
SaturdayClosedClosed
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Closed 9-12 Closed 9-12 Closed Closed Closed
closed 1-5 Closed 1-5 Closed Closed Closed

Testimonial

Dr Gaynor is the absolute best, his numbers one objective is quality of life for your pet. I am always impressed by cutting edge approach as well as his gentleness and compassion. Dr Gaynor has made the last 5 years as pain free as possible for Kaya and we can not thank him enough ❤️

Gene W.
Frisco, CO

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