8120 S. Cass Avenue Darien, IL 60561 | M-F: 8am-12:30pm & 1:30pm-6pm, Saturday: 8am-2pm

Dental Patient History Form and Authorization

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Dental Patient History Form and Authorization

Thank you for giving the team at Burr Ridge Veterinary Clinic the opportunity to care for your animal companion.  To help make check-in faster, please complete the following Dental Patient History Form and Authorization at least two days prior to your pet’s appointment.

You may complete the web form and submit it online below or click the Download PDF Version button to download the form and submit it to staff@burrridgevet.com.

How to download and email the PDF form:

  • Open the fillable PDF version of the form by clicking the button below.
  • Download the blank form to your computer.
  • Complete the fillable PDF form using your computer’s PDF reader program
  • Save the completed form as a new file and e-mail it to staff@burrridgevet.com as an attachment.

If you have any questions or issues with the form, please call us at 630-598-0600.

Download PDF Version
  • Date Format: MM slash DD slash YYYY