New Client Form

Thank you for considering our hospital as your pet’s provider of veterinary services. We are dedicated to maintaining the health of your pet and look forward to many future years together.

 

Please complete this form as fully as possible prior to your first appointment which will help expedite the registration process and give us valuable insight in providing optimal care for your pet(s). The required sections have a red * asterisk.

 

Please note our deposit policies:

 

A deposit (amount of the examination fee) is required for all New Patient and Exotic animal appointments, in order to secure the appointment time. The deposit is refundable as long as a minimum of 24 hour notice is provided to cancel or change the appointment.

 

For Surgeries, we require a deposit of 50% of the estimated cost in order to secure the surgery appointment. This deposit must be paid at least 48 hours prior to the scheduled surgery.

 

CLIENT INFORMATION

 

PET INFORMATION

i.e. Tattoo, Microchip, etc.

Is your pet on any medication or supplement?

 
 
 
Does your pet have allergies or drug reactions?

 
 
Are there any current or past medical conditions of which we should be aware?

 
 
 
Please verify that you are human *