Drop-Off Form

Due to the current COVID recommendations, we have elected to use this form to streamline the drop off process. Please complete this form and let us know when you are ready for a staff member to come out to get your pet by calling (919) 266-9852. Thank you for your patience.
How should we contact you?(Required)
Being responsible for the above-described animal, I have the authority to grant you my consent to receive, prescribe for, treat and/or operate on my pet.

I authorize the personnel of Wake Veterinary Medical Center to:
Perform bloodwork as recommended for my pet.(Required)
Give medication in the hospital and prescribe for home use if needed for my pet.(Required)
Use fluid therapy for my pet if needed as determined by the doctor.(Required)
Update annual vaccinations or recommended diagnostic test; e.g. heartworm, medication rechecks, Feline Leukemia testing.(Required)

I understand a written estimate for these services will be made available upon my request.(Required)
In an effort to maintain a flea-free hospital, if fleas are found on my pet upon admittance to Wake Veterinary Medical Center, I agree to treatment with an appropriate oral or topical flea treatment to prevent spread of those parasite to other hospitalized patients. I understand I will be charged for this treatment.(Required)
I understand that Wake Veterinary Medical Center are not responsible for personal belongings that are left with your pet. We do provide towels and blankets in the cages where all patients are kept.(Required)
While I accept that all procedures will be performed to the best of the abilities of the hospital's staff, I understand that no guarantee has been made regarding the results that may be achieved. I agree to assume financial responsibility and provide payment at the time that services are rendered.(Required)

Owner/Responsible Party
MM slash DD slash YYYY

Wake Veterinary Medical Center

1007 Tandal Place
Knightdale, NC 27545
Phone: (919) 266-9852
Fax: (919) 217-0314
Email: [email protected]

OPEN 24 HOURS EVERY DAY

For after hours emergencies, please call (919) 266-9852.