Everyone has the greatest love for their animals whether a family member, working ranch hand, or competitive team mate. We treat your friend with compassionate care, incorporating the most advanced technology and medical expertise available, offering a full range of health care from routine/preventive maintenance to the most advanced surgery, medicine, and dentistry.  

For your convenience we are now offering PRE-APPOINTMENT FORMS that you can fill out at home prior to your appointments here at the EQUINE CENTER! Simply click on the following LINKS and type in your information. When completed just click 'Send Email' at the bottom and it will forward to us directly. You can also PRINT A COPY and BRING IT WITH YOU to your appointment. (Your typed in name toward the bottom of the forms will be your electronic signature.)

BUYER'S
STATEMENT
EQUINE SELLER'S
STATEMENT
EQUINE
CHECK-IN
EQUINE CHECK-IN
Date of Appointment:    
Owner:    
Street:    
City: State: Zip:
Phone:    
Email:    
Patient:    
Sex: Age: Color:
       
If you are not the Owner, are you:  
    Trainer
Name:

Name:

Address: Address:
Phone: Phone:
       
    Breeder
Name: Name:
Address: Address:
Phone: Phone:
       
Insurance: Medical
    Carrier: Phone:
       
Primary use of horse: Estimated value
of horse:
       

Equine Treatment Authorization:

Treatment of your animal is largely dependent upon the condition that you observe and report.
It is important that you report all details concerning the animal’s behavior or symptoms so that
we can evaluate them in the diagnosis and treatment. Other conditions also may develop from
the stress of illness or injury. If a horse is seriously ill or anesthetized for surgical procedures,
it can develop other conditions, including, but not limited to: diarrhea, laminitis, pneumonia,
severe infections, catastrophic fractures and myositis. Rectal tears are an inherent although rare,
risk of rectal examinations. Although all attempts are made to prevent them from occurring,
a severe rectal tear can be fatal. In certain instances, conditions can be expensive to
treat or potentially incapable of satisfactory resolution. Understand that no guarantee
of successful surgery or treatment is made. In order to help evaluate the health status of your
animal a blood workup may need be done by the treating Doctor with consultation.

By my signature below:

I accept responsibility for payment for all charges incurred and all legal and/or court
cost incurred in connection with collection for services rendered.

Method of Payment must be established before treatment is rendered:

Visa
(name):

I authorize the medical staff of Sturgis Veterinary Hospital/Equine Center to evaluate and treat my animal. The doctors and staff will strive to provide the highest quality of service available for my animal’s medical needs. I understand that there is no guarantee of successful results. By my signature below I acknowledge and accept these risks.

       
Signature:  
Client’s/Owner’s Date of Birth:  
Driver's License #:  
     


     

 

   
24 HOUR
EMERGENCY
 

605-347-4436

 
   
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