WALTZ ANIMAL CLINIC
1300 Osage Drive
Madison, IN  47250
(812) 273-6668
Fax:  (812) 265-3614
waltzanimal@roadrunner.com

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"Our best care for your best friend"
Our mission is to provide quality veterinary medicine and promote regular preventative care so that our patients may enjoy a lifetime of good health.
For your convenience you may print and fill out any of the forms listed below before your visit, or you may fax them ahead. 
Our fax number is  812-265-3614.

Also note, depending on your web browser, you may get a message similar to the following: "TO HELP PROTECT YOUR SECURITY INTERNET EXPLORER HAS RESTRICTED THIS WEBPAGE FROM RUNNING SCRIPTS OR ACTIVE X CONTROLS THAT COULD ACCESS YOUR COMPUTER.  CLICK HERE FOR OPTIONS:"

Rest assured, we are not being sneaky or stealing any information from your computer.  This message is a safeguard built into your web browser for your protection.  To finish printing the form click on the warning message in your internet browser and you will see a short menu with a selection similar to this:  "ALLOW BLOCKED CONTENT."  Click on that choice and you should then be able to click on the "PRINT THIS FORM" shortcut to print the form.

Thanks for your patience.  Here are the forms you may print.  Simply click on the one you need.  A pop up window will appear.  Follow the instructions above if necessary, then click "PRINT THIS FORM."  Afterwards close the form window and you will be redirected to this page so you can print another form if you choose.
This site built and maintained by           Jerry D. Ousley              Jerry Ousley Webs
FIRST TIME VISIT INFORMATION
 
 
ANESTHESIA/SURGERY AUTHORIZATION
 
 
CATHERIZATION/PAIN MEDICATION AUTHORIZATION
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