Service Order Form # 7


Go Back To Pet Purchase Forms
( For Customers In The Process Of Purchasing A Puppy )


Instructions for Pet Purchase


Pet Insurance

Primary Information Pages
Find the answer to most commonly asked questions.
This is the center of our web site were we list all of our information pages.
Very helpful to customers that are new to our web site.
MANDATORY PET HEALTH EXAM

PLEASE CLICK OPEN FORM TO PRINT.
 
THIS FORM MUST BE COMPLETED WITHIN 3 DAYS OF RECEIVING YOUR NEW PUPPY AND RETURNED BY CERTIFIED MAIL ACCORDING TO THE  HEALTH  GUARANTEE. 


Click Here To Open In A Pop Up Printable Form

 

CLICK GREEN ARROW
To Continue With Step In Puppy Purchase
Vet Credit Form

 

BELOW IS AN EXAMPLE OF WHAT THE FORM LOOKS LIKE

                                       Teacup and Toy Pet Boutique 
                                                                                                         10308 US HWY 80  Forney, TX  75126 

www.TexasTeacups.com  CustomerService@TexasTeacups.com    

Phone 1-972-552-1989 or 552-9132  Fax : 480-247-4749
 

MANDATORY PUPPY & PET HEALTH EXAM 2010

Fecal exam & parvo test is mandatory to validate health guarantee.

( Must be completed within 3 days of receiving your new puppy )
( Modified Date: 5-27-2010 )
 
Puppy Number # ______________________________________
 
Breed:________________________________________________

 

Sex: ___________________ Date of Birth: _____________________    

 
1.     Fecal Exam by a licensed veterinarian:
Veterinarian will check for these worms, parasites & their eggs that can only be detected under a microscope.
 

                           PARASITEDS FOUND IN FECAL

 

Coccidian: Mild:___ Moderate:____ Severe:____ Eggs Only:   YES or NO

                                             
Giardia: Mild: ____ Moderate:____ Severe:____ Eggs Only:   YES or NO

 

                            WORMS FOUND IN FECAL  

 

Strongyloides: Mild:_______ Moderate:_________ Severe:_______ Eggs Only:   YES or NO         

 

Roundworms: Mild:_______ Moderate:_________ Severe:_______ Eggs Only:   YES or NO

 

Tapeworms: Mild:_______ Moderate:_________ Severe:________ Eggs Only:   YES or NO

 

Whipworms: Mild:_______ Moderate:_________ Severe:________ Eggs Only:   YES or NO

 

Hookworms: Mild:_______ Moderate:_________ Severe:_______ Eggs Only:   YES or NO

 
2.     PARVO TEST: Positive:____________ Negative:____________

      Exact date of Parvo Test:_______________________________

 
 ___________________________________________________________________________
              ^   Name of Veterinarian Clinic or Hospital 
 
_____________________________________________________________
          ^ Signature of Licensed Veterinarian that completed this form ^   
 
     ________________________________________________________________
   Contact Phone Number            /         Date of Signature     
 
    
    
=============================================
Below is a list of items we suggest you have checked at your puppy’s first office visit.

Dental Exam: Correct bite, no missing teeth, no abscesses, and etc. YES _______ NO _______
3. Ear Exam:

Ears are free from mites, inflammation, and visible signs of infection. YES _______ NO _______
4. Eye Exam:

Eyes are free from entropia, evidence of corrective surgery, corneal scars, cataracts and visible flaws. YES _______ NO _______
5. Glucose, Anemia: Free of glucose or anemia problems. YES _______ NO _______

Hair and Skin Exam: Free of mange mites: YES _______ NO _______

Fleas: YES _______ NO _______ Eggs Only:   YES or NO

Ticks YES _______ NO _______ Lice: YES _______ NO _______

Other Parasites: ______________________________________________________________

Infections and any abnormal skin conditions: YES _______ NO _______
7. Heart Exam: Free of heart murmur.  YES _______ NO _______
8. Hernia Exam: Free of hernia. YES _______ NO _______
9.  Abnormal Open Fontanel: YES ____NO ____ Mild: ____Moderate:_____ Severe: _____
10. Leg Exam: Visually Noticeable Luxating Patella, other MS problems. YES _______ NO _____
11. Reproductive Exam: Male has two testicles. YES _______ NO _______
12. Respiratory Exam: Lungs have a normal respiratory sound on both sides.

      Free from congestion and cold symptoms. YES _______ NO _______

 

 This business is owned and operated by the grace of God
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