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New Client Form

Thank you for giving us the opportunity to care for your pet. So that we may become better acquainted, please complete the following information.

TELEPHONE NUMBER
How may we contact you?
How did you hear about us?
ABOUT YOUR PET(S)

Please tell us about your pet(s). For our records, please provide us with your pet(s) last vaccine records and/or medical records.

PET INFORMATION
Sex
Spayed/Neutered
Resuscitate in case of emergency
PET INFORMATION
Sex
Spayed/Neutered
Resuscitate in case of emergency
PET INFORMATION
Sex
Spayed/Neutered
Resuscitate in case of emergency
PET INFORMATION
Sex
Spayed/Neutered
Resuscitate in case of emergency
RULES AND AGREEMENT

Payment Information: Professional fees are due at the time services are provided. When possible, you will receive an estimate of fees before treatment is started. A 50% deposit of the estimated total is due before treatment is started, and payment in full is due at the time patient is discharged. Depending on the progress of the patient, fees more than the original estimate may be incurred. If fees are substantial, we will attempt to contact you prior to incurring the fees. If verbal authorization is given, you will be responsible for additional fees. Any patient being discharged must be picked up by closing that day or there will be additional hospitalization charges.

Payment Options: We accept tall major credit cards for your convenience, as well as offer Care Credit and Scratch pay as payment plans.

Returned Checks: There will be a returned check charge of $35.00 for returned checks.

We have the right to cancel your privilege to receive veterinary treatment for any animal due to an unpaid balance and you have the right to refuse treatment at any time for any reason. By signing below, you agree that you are responsible for all fees incurred. This includes any medication and diagnostic procedures. The responsibility continues if the patient fails to recover or is euthanized. I hereby authorize the veterinarian to examine, prescribe for, or treat my pet. I assume responsibility for all charges incurred in the care of this animal. I also understand that these charges will be paid at the time of release and that a deposit may be required for surgical or extensive medical treatment.

Appointments: I agree to call in advance if I am unable to make my scheduled appointment. I agree that if I do not communicate that I am unable to make my pet's appointment, I will be subject to a "No Call / No Show" Fee.

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