Lincoln Land
Animal Clinic, Ltd

Dr. Joseph Koch    Dr. Colleen Koch   Dr. Jennifer Banks
217-245-9508

Lincoln Land Animal Clinic, Ltd

1150 Tendick
Jacksonville, IL 62650

(217)245-9508

lincolnlandac.com

You can assist us to expedite your check in by submitting the appropriate form from the list below.  All forms are in pdf format so they are fillable and may be submitted electronically.  

If you have Adobe Acrobat XI, simply download the appropriate form and fill.  If you have the Adobe Acrobat Reader only, you will need to download the newer version of Adobe as stated above. This is a free download.  If you have a Mac you can use preview (a program that comes with your Mac computer) to fill out the forms.

Alternatively, you may download the forms as Word documents. The word documents have drop down lists and are best suited to be completed on your computer.

After your form is completed, you may submit it to llanimalclinic@yahoo.com.

Forms may also be handwritten and submitted in-person at the time of your appointment.  For handwritten behavior forms, please submit by fax, mail, or scan as the doctor will need the information prior to your appointment.

Thank you for your cooperation in letting us assist you.


File NameDescription / Comment
Application for EmploymentIf you are interested in working with us to help pets, please complete the employment application. When we are actively hiring, this is the first place we look!
Application for Employment WordIf you are interested in working with us to help pets, please complete the employment application. You can email it to us, or bring your completed form in so we can meet you!
Behavior Consult ChecklistThis convenient checklist will enable you to complete your questionnaire and help you prepare for your pet's behavioral consult.
Behavior Questionnaire- Cat wordPlease download this form and return it to the office at least 48 (72 hours is best) prior to your pet's behavior consultation. This version was designed to be downloaded and completed on your computer. In addition please review the Behavior Consult Checklist and Referring Veterinarian Form.
Behavior Questionnaire- Cat pdfThis form can be filled out on your computer, or printed off. The drop boxes on the word document have been converted to check boxes on this form.
Behavior Questionnaire- Horse wordPlease download this form and return it to the office at least 48 (72 hours is best) prior to your pet's behavior consultation. In addition please review the Behavior Consult Checklist and Referring Veterinarian Form.
Behavior Questionnaire- Horse pdf
Behavior Questionnaire-Dog wordPlease download this form and return it to the office at least 48 (72 hours is best) prior to your pet's behavior consultation. This version was designed to be downloaded and completed on your computer. In addition please review the Behavior Consult Checklist and Referring Veterinarian Form.
Behavior Questionnaire-Dog pdfThis version can be filled out on your computer of printed off. The drop boxes on the word document have been converted to check boxes on this form.
Behavior Questionnaire-Recheck Form all species- wPlease fill out this form and return it prior to your recheck behavior appointment.
Behavior Questionnaire-Recheck Form all species-pd
Behavior Referring Veterinarian Form- wordIf you are a referring veterinarian please fill out this form and submit it prior to your client's consultation. If you are an owner please have your veterinarian complete this form prior to your consult.
Behavior Referring Veterinarian Form-pdf
Consent for Services or Surgery-pdf Complete this form and return prior to your pet's procedure (surgery, dental, x-rays, bloodwork, day admission) and check in will be a breeze- all you will have to do is sign your name the morning of the procedure.
Consent for Services or Surgery - WordComplete this form and return prior to your pet's procedure (surgery, dental, x-rays, bloodwork, day admission) and check in will be a breeze- all you will have to do is sign your name the morning of the procedure.
Day Admittance QuestionnairePlease fill out this form in addition to the consent form if you are going to be leaving your pet with us for an examination or treatment. The details of this questionnaire will help us diagnose and treat your pet.
Day Admittance Questionnaire Word
New Client InformationPlease fill out the new client information form if you will be visiting us for the first time.
New Client Information Word

We are now offering
Laser Surgery
Digital Radiographs (Dental and Routine)
Small Mammal/Pocket Pet Medicine and Surgery
and
Behavioral Counseling

Private training for problem behaviors in dogs, cats, horses and other species

Resident in Behavior Medicine
Graduate of the
Karen Pryor Academy


Lincoln Land Animal Clinic, Ltd.
1150 Tendick Street
Jacksonville, IL 62650
217-245-9508


Dr Joseph Koch
Dr Colleen Koch

Dr Jennifer Banks




Hours
M-F 7:30am- 5:30 pm
Saturday 8 am- 1pm