Spreadsheet: 6df6e985-8965-4412-a5d0-076a57ad415c
Sheet: Sheet1

Unnamed: 0 | Form: Sample travel sheet for veterinary appointments | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | Unnamed: 11 | Unnamed: 12 | Unnamed: 13 | Unnamed: 14 | Unnamed: 15 | Unnamed: 16 | Unnamed: 17 | Unnamed: 18 | Unnamed: 19
 | Check-in time __________  Appt. time __________  Checkout time __________  Dr. ______________  Tech ___________
 | Client number _________________  Owner's name ________________________  Pet's name _________________________
 | Date ________  History                                                                         Number of transactions _______  Receptionist ___________
 | PROFESSIONAL SERVICES |  |  | X | UNIT | LAB & DIAGNOSTICS CONT. |  |  | X | UNIT | SURG/DENT PROCEDURES |  |  | X | UNIT
 | PS5 | Medical Exam L1 | Phys/med exam |  |  | LS74 | Fel [NAME] |  |  |  |  | Surgery Type: ST, OR, EM
 | PS6 | Medical Exam L2 |  |  |  | LS002 | Fine Needle Aspirate (FNA) |  |  |  | SR60C | Surgery Room/ Supplies
 | PS2 | Medical Exam L3 |  |  |  | NACC | FNA & Cytology (In-house) |  |  |  | [NAME] | [NAME].
 | PS13 | Wellness Exam |  |  |  | [NAME] | Felv/Fiv test (In-side) |  |  |  |  | Estrus/ Preg Charge
 | PS10 | Follow-up Exam |  |  |  | LS024 | [NAME] |  |  |  | DN1A | Dental Cleaning
 | EC02 | Euthanasia Consult |  |  |  | LS025 | Fungal Culture |  |  |  | DN2 | Dental (Add on)
 | PC | Phone Consult |  |  |  | LS32A | Glucose (in-house) |  |  |  | DNX | Dental Extractions
 | SPC | Specialist [NAME] |  |  |  | T615 | Heartworm Test (Out-side) |  |  |  | DN18 | Fluoride Tx w/ Dental
 | WELLNESS PLANS |  |  | X | UNIT | MHS | Medical Health Screen
 |  | Puppy Well Plan Visit # ______ |  |  |  | MHSI | Medical Health Scrn ( in-side)
 |  | Kitten Well Plan Visit #  _______ |  |  |  | HHS | Heartworm Health Screen |  |  |  | ANESTHESIA |  |  | X | UNIT
 | WCP | [NAME] |  |  |  | SHHS | Sr. Heartworm Health Screen |  |  |  | AN001 | Iso Inhalation Anesth
 | WCPSA | Well Plan, Semi-annual |  |  |  | T450 | Low Dose Dex Test (3 samples) |  |  |  | AN002 | [NAME],ext-1/2 hr
 | CAT VACCINES |  |  | X | UNIT | LS057 | Parvo Test | TOTAL HEALTH W/FELV,FIV,FIP,T4 |  |  | PREA | Pre-Anesth Inject
 | VC300 | FVRCP Booster |  |  |  | LS034 | PCV/TS |  |  |  | IND | [NAME]
 | [NAME] | FVRCP Annual |  |  |  | T750 | Phenobarb Level |  |  |  | AN006 | [NAME] hr
 | [NAME] | FELV Booster |  |  |  | LS047 | [NAME]
 | VC303 | FELV Annual |  |  |  | [NAME] | Schirmer Tear Test |  |  |  | RADIOGRAPHS |  |  | X | UNIT
 |  |  |  |  |  | SKC | Skin Cytology |  |  |  | XR005 | Initial Plate w/review
 | CAT AND DOG |  |  | X | UNIT | T495 | Thyroid Level - T4 |  |  |  | XR006 | 2nd  view
 | VC100 | Rabies 1 Yr |  |  |  |  | Thyroid Panel: ________ |  |  |  | XR3+ | 3rd view and more
 | VC101 | Rabies 3 Yr |  |  |  | TO102 | Tonometry |  |  |  | XR007 | [NAME] (2Views)w/r
 | DOG VACCINES/OTHER |  |  | X | UNIT | WDL | Woods Lamp |  |  |  | INJECTIONS/MISC. SERVICES |  |  |  | UNIT
 | VC207 | Bordetella Booster Nasal |  |  |  | LS054 | Urinalysis (U/A)-In-house |  |  |  | IN048 | [NAME].
 | [NAME] | Bordetella Annual Nasal |  |  |  | T760 | Urinalysis (U/A)-Outside |  |  |  | REACT | Anti-vacc reaction inj
 | VC208B | Bordetella Booster Inject |  |  |  | [NAME] | Cystocentesis
 | VC208 | Bordetella Annual Inject |  |  |  | TX8 | Urinary Catheter
 | VC203 | [NAME] |  |  |  | TREATMENTS |  |  | X | UNIT
 | [NAME] | Corona Annual |  |  |  | AR001 | Additional Restraint
 | VC200 | DHPP Booster |  |  |  | TX1 | Anal Gland: Express
 | VC201 | DHPP Annual |  |  |  | TX1P | Anal Gland -  Infuse
 | VC404 | Lepto Booster 4 way |  |  |  | TX2 | Bandage Small |  |  |  | MEDS/SUPPLIES |  |  | X | UNIT
 | VC405 | Lepto Annual 4 way |  |  |  | TX3 | Bandage Large |  |  |  | M01 | [NAME].
 | VC205 | Lyme Booster |  |  |  | [NAME] | Catheter. I.V.
 | [NAME] | Lyme Annual |  |  |  |  | Clip/ Scrub: Level 1,  2,  3,  4
 | VPORPHB | [NAME] |  |  |  |  | Ear Clean: Level  1,  2,  3,  4
 | VPORPHA | Porphymonas Annual |  |  |  | EARP | Ear Plucking/Epilation
 | LAB & DIAGNOSTICS |  |  | X | UNIT | TX8M | I.V.  Infusion Pump
 | BD001 | Blood Draw Fee |  |  |  | TX13 | [NAME]
 | MW001 | Medical Waste |  |  |  | TX14 | Fluids I.V.
 | T440 | ACTH Response Test |  |  |  | [NAME] | Fluids I.V. w/ Catheter
 | SA055 | Basic Bld/ Hlth Scrn (Out) |  |  |  | HS001 | Hospitalization 1st Day
 | LS031 | Basic Bld/ Hlth Scrn (in) |  |  |  | HS003 | Hospitalization 2nd + DAYS
 | FBX | Biopsy 1st  site |  |  |  | HS002 | Hospitalization 1/2 day
 | FBX ADD | Biopsy Each  addit Site |  |  |  | OTO | Otoscopic Evaluation |  |  |  | RECOMMENDED SERVICES |  |  | X | UNIT
 | LSMISC | [NAME]. | Total Health Screen |  |  | OPT | Ophthalmologic Evaluation |  |  |  | RAT | Arthritis Treatment
 | SA020 | [NAME] (out) |  |  |  | POX | Pulse oximeter |  |  |  | RBP | Blood Pressure
 | LS2 | [NAME] (in) |  |  |  | DPT | Proced/ tx time (mins): Dr. |  |  |  | DN7 | Dental
 | CMHS | Compr Med Hlth Scrn (in) |  |  |  | TPT | Proced/ tx time (mins):Tech |  |  |  | RDW | Diet/ Weight management
 | SA120 | Compr [NAME] |  |  |  | VAPT | Proced/ tx time (mins): V.A. |  |  |  | RFE | Fecal Exam (Intestinal Parasites)
 | 1620 | Compr Bld/ Urine Hlth Scrn |  |  |  | PS14 | Nursing Care |  |  |  | RHS | Health Screen
 | SA225 | [NAME] Bld/ Hlth Scrn |  |  |  | TX20 | Suture Removal |  |  |  | RHT | Heartworm Test
 | 1618 | [NAME] Bld/ Urin Hlth Scrn | Cytology (Outside) |  |  | TX200 | Staple Removal |  |  |  | [NAME] | Mass Removal
 |  | Culture: Type:____________ |  |  |  | TX17 | [NAME] |  |  |  | RO | Other:  ________________
 | CYTO | Cytology  per 1 site |  |  |  | E&C |  |  | X | UNIT | RSN | [NAME]
 | DS | Dermatitis Screen |  |  |  | EC1 | Euth |  |  |  | RUA | Urinalysis | Health Screen Recommend
 | LS3 | Diagnostic Screen |  |  |  | EC2 | [NAME] < 90
 | ES | Eye Screen |  |  |  | EC3 | [NAME] |  |  |  | OTHER SERVICES |  |  | X | UNIT
 | [NAME] | Ear Cytology |  |  |  |  | Priv Crem: Wt: ______ |  |  |  |  | Medication Monitor Misc. ___________
 | LS0015 | Ear Swab for [NAME] |  |  |  | BOARDING/GROOMING |  |  | X | UNIT | [NAME] | Arthritis Med Monitor
 | T805 | Fecal Centrifugation (Lab) |  |  |  | BD004 | Brd Dog/day |  |  |  | SMM | Seizure Med Monitor
 | [NAME] | Fecal (Float) - In-house |  |  |  | BD010 | Brd Cat/ day |  |  |  | TMM | Thyroid Med Monitor
 | LS017 | Fecal (Float): [NAME] |  |  |  | BD012 | Board w/ med |  |  |  | CALL BACK:  ___________, # ____ DAYS
 | LS0016 | Fecal Exam (Direct) |  |  |  |  | [NAME] : Breed ________ |  |  |  | PS0__ | Recheck/ Next visit  7   10   14   21  days
 | FLUA | [NAME]: ______ |  |  |  |  | Bath     _______ [NAME]'s |  |  |  | OS9 | Enter Weight
 | Pills: | 1) 1 Tb Sid, 2) 1/4 Tb Bid, 3) 1/2 Tb Bid, 4) 1 Tb Bid, 5) 1 1/2 Tb Bid, 6) 2 Tb Bid, 7) 1/2 Tb Tid, 8) 1 Tb Tid, 9) 1/2 ml Bid, 10) 1 ml Bid
 | Pred: | 9) 1 Tb Bid x 3 Dys, 1 Sid x 3 Dys, 1 Eod unitl gone, 10) 1 Tb Bid for 5 Dys,  1 Sid x 5 Dys,  1 Eod untill gone, 11) = 1/2 of #9, 12) =1/2 of # 10
 | EENT | 13) 5 drops a.u. Bid x14 Days, then Recheck, 14) Cleanse ears 2x / Wk x 3wks, then monthly, 15) 1 drop o.u. Bid x 10 days,
 | Rx:
 | Rx:
 | Rx:
 |  | Source: Dr. [NAME], Progressive Pet Animal Hospitals, Michigan