Sunshine Coast - early 2025
Call Now
Stafford: 07 3359 0777
North Lakes: 07 3384 2222
Services
24 Hour Pet Emergency
Critical Care
Internal Medicine
Oncology
Outpatient Ultrasound
Surgery
Hip and Elbow Scoring
Minimally Invasive Surgery
Laparoscopic Gastropexy
Dentistry
Reproduction
Dermatology
Cardiology
Advanced Imaging
Anaesthesia
Physiotherapy
Common Conditions
Patent Ductus Arteriosus
Periodontal Disease
Feline Stomatitis
Cruciate Ligament Disease
Medial Patella Luxation
Minimally Invasive Surgery
Elbow Dysplasia
Total Hip Replacement
Hip dislocation
Intervertebral Disc Disease
Brachycephalic Airway Syndrome
Hiatal Hernia
Gastric dilatation and volvulus (GDV)
Laryngeal Paralysis
Humerus fractures
Lameness
Carpal (wrist) trauma
Pancreatitis
Perineal urethrostomy
Pyometra
Caesarean After Care
Perineal Hernia
Endoscopic Foreign Body Removal
Gastrointestinal foreign body surgery
Facilities
Virtual tour
Digital Radiography
CT
MRI
Ultrasonography
Endoscopy
Laparoscopy
Arthroscopy
Ligasure
Lab Suite
Intensive Care Unit
Our Team
Emergency and Critical Care
Internal Medicine
Cardiology
Surgery
Radiology
Dentistry
Reproduction
Dermatology
Anaesthesia
Physiotherapy
Payment
Payment options
Finance options
Referrals
Referrals
Outpatient Ultrasound Service
Client info
COVID-19 Update
FAQs
Making an appointment
What is a specialist?
Recovery after orthopaedic surgery
Quality of life
Blood Donor Program
Contact
Employment Opportunities
Vet Portal
Sunshine Coast - early 2025
Call Now
Stafford: 07 3359 0777
North Lakes: 07 3384 2222
Services
24 Hour Pet Emergency
Critical Care
Internal Medicine
Oncology
Outpatient Ultrasound
Surgery
Hip and Elbow Scoring
Minimally Invasive Surgery
Laparoscopic Gastropexy
Dentistry
Reproduction
Dermatology
Cardiology
Advanced Imaging
Anaesthesia
Physiotherapy
Common Conditions
Patent Ductus Arteriosus
Periodontal Disease
Feline Stomatitis
Cruciate Ligament Disease
Medial Patella Luxation
Minimally Invasive Surgery
Elbow Dysplasia
Total Hip Replacement
Hip dislocation
Intervertebral Disc Disease
Brachycephalic Airway Syndrome
Hiatal Hernia
Gastric dilatation and volvulus (GDV)
Laryngeal Paralysis
Humerus fractures
Lameness
Carpal (wrist) trauma
Pancreatitis
Perineal urethrostomy
Pyometra
Caesarean After Care
Perineal Hernia
Endoscopic Foreign Body Removal
Gastrointestinal foreign body surgery
Facilities
Virtual tour
Digital Radiography
CT
MRI
Ultrasonography
Endoscopy
Laparoscopy
Arthroscopy
Ligasure
Lab Suite
Intensive Care Unit
Our Team
Emergency and Critical Care
Internal Medicine
Cardiology
Surgery
Radiology
Dentistry
Reproduction
Dermatology
Anaesthesia
Physiotherapy
Payment
Payment options
Finance options
Referrals
Referrals
Outpatient Ultrasound Service
Client info
COVID-19 Update
FAQs
Making an appointment
What is a specialist?
Recovery after orthopaedic surgery
Quality of life
Blood Donor Program
Contact
Employment Opportunities
Vet Portal
Blood Donor Program – Register your Dog
Canine Blood Donor Program Registration
OWNER INFORMATION
Name
First Name
Last Name
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email
Mobile phone
Alternative phone
PRIMARY CARE VETERINARIAN INFORMATION
Regular Veterinarian:
Veterinary Clinic:
CONSENT FOR BLOOD DONATION
I give consent for an initial health check, which includes physical examination, temperament assessment, blood tests, +/- urine analysis. I am aware that no additional fee is incurred for these tests. Results will be shared with my regular veterinarian. I understand that blood donation may require sedation and/or general anaesthesia. It is the priority of Queensland Veterinary Specialists/Pet Emergency to provide our donors with a safe and positive donation experience. I understand the risks associated with sedation/general anaesthesia and consent to sedation/anaesthesia if required. I understand that to minimise infection, small areas of hair will need to be clipped from my dog’s neck and legs. I, the owner, hereby give consent for my dog to donate blood under the care of Queensland Veterinary Specialists/Pet Emergency.
Signature
Date
MM
DD
YYYY
PET INFORMATION
Pet's name
Pet's breed
Pet's age
Pet's date of birth
MM
DD
YYYY
How old was your dog when you obtained him/her?
Pet's sex
Male
Female
Spayed/Neutered:
Yes
No
Vaccination
C3
C5
C7
None
Vaccination product name and date received
Heartworm prevention
Yes
No
Heartworm product name and date received
Tick prevention
Yes
No
Tick prevention product name and date received
Flea prevention
Yes
No
Flea prevention product name and date received
Has your dog ever received a blood/plasma transfusion
Yes
No
Has your dog ever received Tick Antiserum
Yes
No
Has your dog ever received Snake Antivenom
Yes
No
Has your dog ever been pregnant?
Yes
No
Does your dog go outdoors unsupervised?
Yes
No
Do you travel with your dog? If so, where?
Does your dog have or has your dog had any medical conditions/illnesses? Please provide details
Is your dog receiving any medications or supplements?
Has your dog been a blood donor previously? Please provide details
OWNER DECLARATION
I declare that all information provided is accurate to the best of my knowledge, as failure to do so may place my dog and others at risk.
Signature:
Date
MM
DD
YYYY
Thank you!