Online Forms

For your convenience, Carmel Veterinary Clinic provides our forms online, so you can complete them from the comfort of your home at a time that works best for you.

New Client

New Client
If you’re new to our veterinary hospital or we’ve never seen your pet before, please fill out and submit our new client form below.

Information About You

Name
Name
First Name
Last Name
Address
Address
City
State/Province
Zip/Postal
Emergency Contact
Emergency Contact
First Name
Last Name
How Did You First Hear of Us?

 

Prescription Refill

Prescription Refill
Does your pet need a refill on their prescription? Complete your request here.

Please fill in this form as completely as possible. Please allow at least 24 hours for refill request to be processed. We will contact you if there are any problems with your request.

Please also note that this form is for refills of medications dispensed by our offices. Requests for medications dispensed by outside pharmacies may be submitted by emailing us on the “Contact Us” page or by phoning one of our offices.

Name
Name
First Name
Last Name
Do you prefer to be called or texted?
Species
Pet’s Sex

 

Records Release

Release of Medical Records
Use this form to provide written authorization to our veterinarians to release your pet’s medical records.
Name
Name
First Name
Last Name
Address
Address
City
State/Province
Zip/Postal

In accordance with Indiana State Law, pet medical records may not be disclosed without the client's written consent to "any person other than the client or other veterinarians involved in the care or treatment of the animal".

This document serves as my authorization for a veterinarian (or his/her designee) at Fishers Veterinary Associates to release the medical history of any of my pets as deemed necessary at the time of the request including medications and/or treatments past and present.

This document shall be placed in my file and is in effect immediately upon receipt by that facility and/or the date below, and shall remain in effect until written
instructions direct otherwise.

By signing this agreement, I authorize Fishers Veterinary Associates to provide a copy, summary, or narrative of my pet's medical records or to otherwise release confidential information for all pets on my account.

 

Cat Looking At Owner On Laptop