Paperwork For the Benton City Clinic

It is important that you and the animals you are bringing come prepared for the clinic.  Make sure that you have read and followed the instructions for preparing for the clinic.

At least one day prior to the clinic download, print, and COMPLETE the forms below that apply to the animal(s) you’re bringing to the clinic.  It saves time and confusion bringing these completed forms with you when you drop off your animal(s).

Just click on the form(s) that you need for the animal(s) that you’ll be bringing.  After the form loads click on the printer icon.  You will need a printer.  If you don’t own a computer the local libraries have computers that you can use for free.  Check with your area library for printing costs.

Unsure of how to complete the forms?  Just click on the link at the bottom of the page to view an example of completed forms.

Forms For Cats  (3 Forms)
Feline Medical Record  
Instructions:  Print a copy for EACH cat you are bringing.  Complete the top half of the form up to Clinic Use Only

Rabies Form
Instructions
:  There are two of the same form per printed sheet.  Print additional sheets if you are bringing more than two cats.  Complete the first two lines of each form you need (one form per cat).

Release of Authorization
Instructions: Surgical Release Form for individuals with seven (7) or less cats.  List EACH animal that you are bringing and complete the information for each.

Release Form for shelters and rescues.  Two pages offers more space for the larger number of animals being brought in.

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Forms for Dogs:
Canine Medical Record  
Instructions:  Print a copy for EACH cat you are bringing.  Complete the top half of the form up to Clinic Use Only

Release of Authorization
Instructions: There are several entry lines per form.  List each animal that you are bringing and complete the information for each.  If you need more print additional release forms.  Two (2) page form for Shelters and Rescues.

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Example of Completed Forms: