Preferred Payment Type*
AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
Driver's License #
Employer's Street Address
Work Phone Number
---DogCatOther (Please Specify In Notes)
If yes, what year?
Any known drug allergies?
Last Vaccination Dates
If you have documents pertaining to your pet's medical history, you may attach them below:
2001 Sweets Drive,
Carbondale, IL 62902
Phone: (618) 529-2236
“ Phenomenal kindness and care, very thorough explaining our kitty's illness, treatment and follow up plans. Denise B.
Phenomenal kindness and care, very thorough explaining our kitty's illness, treatment and follow up plans.
“ Lakeside treats my pets like family. The vets are extremely knowledgable and the staff is very friendly. Martha A.
Lakeside treats my pets like family. The vets are extremely knowledgable and the staff is very friendly.
Your confidence in our service and the sharing of our name is what helps us grow. To show our appreciation in your trust, both you and your referral will receive a $25 account credit.