NEW CLIENT FORM

We are dedicated to providing the highest level of veterinary medicine along with friendly, compassionate service.

Welcome New Clients

Please complete the form below before your visit.

At this time we are NOT accepting new clients for urgent or emergent matters. Currently, we are still accepting new clients for routine surgeries and wellness/vaccination exams. We are booking 3-5 weeks in advance for these services.

Name *

First

Last

Email *

Primary Phone *

Secondary Phone

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Who else is authorized to make decisions about your pet's healthcare? *

First

Last

Phone

How did you find out about our hospital? If you were referred by someone, who should we thank? *

Pet's Name *

Species (dog, cat, equine, etc.) *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Payment is due in full at the time that services are performed. If being admitted into the hospital, we cannot begin the care of your Pet until you have confirmed your desire to do so by 1) signing the client consent & estimate form, and 2) leaving an initial deposit of 50% of the upper end of the estimate. This is the only way that we have of knowing for certain that you want us to proceed with the care of your Pet. We accept cash, debit, VISA, M/C, e-transfer, or ScratchPay. We neither extend credit, nor bill for services. All open invoices are sent to collections after 45 days unless prior arrangements are made. *

I have read and accept the financial policy.

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NEW CLIENT FORM

Welcome New Clients

Location

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