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New Client Form

Owner Information

Owner Name(Required)
Secondary Owner Name
Address(Required)
Home or cell?
Home or cell?
Email(Required)

Patient #1 Information

Sex(Required)

Patient #2 Information

Sex

Our Fee Policy: All fees are due at time of service. We accept Cash, Checks, Debit, Visa, MasterCard, American Express, Discover, Care Credit, Apple Pay, and Trupanion Insurance.

Consent: I hereby authorize the veterinarian to examine, prescribe for or treat the above described pet(s). I understand that all animals must be current on vaccinations and testing for boarding, grooming, daycare, and hospital procedures. I assume all responsibility for all charges incurred in the care of my animals. I also understand that these charges will be paid for at the time of release and that a deposit may be required for surgical treatments or hospitalization.

Cancellation Policy: I understand that if I do not cancel or reschedule my appointment prior to 48 hours of my appointment time, or failure to attend my appointment will result in a cancellation/no-show charge which must be paid prior to booking another appointment.

By signing below, I understand and agree to the conditions above.

Date(Required)

*New Client? Please tell us who referred you for both you and them to receive a referral bonus added to your account!