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Client Information

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Patient Information

Is your pet spayed/neutered?
MM slash DD slash YYYY

Start with the bracketed "p"

Use the bracketed "br/" for two line breaks

List items

  1. "ol" means ordered list
  2. "ul" means unordered list
  3. List Item 1
  4. List Item 2
  5. List Item 3


"strong" will bold words

"u" will underline words

Last information listed and end with a "/p" tag!

Cardiopulmonary Resuscitation (CPR) Directive

I understand Veterinary Specialists of the Rockies (VSR) requires a CPR status prior to the start of any and all procedures so immediate action can take place in the event of cardiopulmonary arrest during, before, or after anesthesia or anytime in our care. I acknowledge that the attending veterinarian or staff members of VSR will make every effort to contact me regarding treatment in the case of this unforeseen event. The starting cost of CPR is approximately $400.

I am the owner / agent of this pet and I ...

Signature Section

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