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MEDICATION LOG FORM

(All fields with an * are required.)

**PLEASE BE ADVISED A CAN OF FOOD WILL BE INVOICED TO ADMINISTER MEDICATION OR YOU CAN BRING FOOD/TREAT/USUAL METHOD THAT YOU USE AT HOME TO GIVE THE MEDICATION.**

LIST ALL MEDICINES YOUR PET IS CURRENTLY TAKING THAT YOU ARE BRINGING IN FOR US TO ADMINISTER: Prescription and over-the-counter medications (examples: antacids, allergy) and herbals (homeopathic). Include medications taken as needed (example: anti-diarrheal). All medications.

**Be very specific, please.**

I have completed and reviewed this Medication Log Form and consent to the administration of the medications as indicated in my directions. If Babcock Hills Veterinary Hospital has any questions or concerns as we begin to administer the medications, we will contact you at the telephone numbers you provided above.

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