Client Information


Welcome

We are pleased to welcome you to our practice. Please take a few minutes to fill out this form as completely as you can.

If you have questions we'll be glad to help you. We look forward to working with you in maintaining your pet's health.

Client Information
Spouse or co-owner
Notify in case of Emergency
Pet Information
Describe Any:
Payment

We will gladly prepare a written estimate of service fees if you desire (please ask out doctor or receptionist). All professional fees are due at the time services are rendered. In cases of extensive medical or surgical procedures where full payment may be difficult at discharge, we accept major credits cards or can establish a payment arrangement if approved in advance of treatment. There will be service charge for any check returned unpaid.

To prevent the spread of infectious diseases, all hospitalized patients must be current on all vaccines and free from internal and external parasites. The signature or aggrement below authorizes this level of preventive care and the appropriate charges will be assessed in the discharge invoice.

PHOTO CONSENT: We love social media! Do we have permission to share your pet's image and story on social media, our websites, or other form of media? Your name and information will NEVER be shared.