Now serving all of the GTA through our longstanding location in North York and our new Mississauga location.

Patient Admission Form

Lakeshore Animal Hospital in Mississauga, ON

  • If your pet is experiencing a medical emergency, call us at 905-858-6767 or bring them to our hospital immediately.
  • To expedite the admission process, please complete the form below before or upon arrival, if possible.
  • Your pet’s medical records will be forwarded to your family/daytime veterinary hospital after your visit.

Emergency Fee + Consult Emergency: $331.91 taxes included

All fields marked with * are required and must be filled.

OWNER INFORMATION

Only the primary contact will be receiving medical updates from the doctors.

 

AUTHORIZED REPRESENTATIVE AND/OR EMERGENCY CONTACT INFORMATION

If I am not available, then the individual named above is authorized to:

 

Make financial decisions on my behalf regarding my pet. *
Make medical decisions for my pet on my behalf. *

SECONDARY CONTACT (IF APPLICABLE)

PET INFORMATION

Sex *
Is your pet insured *
Emergency Life Saving Authorization *

 

Should my pet's condition worsen, I wish for the veterinarian to perform CPR and other life-saving measures while trying to contact me. I agree to be responsible for the costs of such measures and understand that these measures may lead to costs greater than my initial treatment/procedure estimate.

Critical Consent Authorization *

 

I approve the veterinarian to perform an IV catheter placement, IV fluids, in-house blood work and emergency imaging. The veterinarian will only perform treatments and diagnostics required to stabilize your pet and will speak to you prior to performing any further procedures.

 

The critical consent deposit is $800 and should cover the cost of these initial measures. Any further costs will be discussed with you by the veterinarian.

CRITICAL CONSENT FEE: $800 TAXES INCLUDED

Security Question *