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New Client Form

Thank you for choosing our hospital! We look forward to getting to know you and your pet. Please help us to provide the best care possible for your pet by taking a moment to fill out this form.

Client / Owner Information
For identification and payment purposes, a copy of any authorized individual’s drivers license is required.
Spouse / Co-Owner Information
How did you hear about us?
Please check all that apply.
Doctor Referral
If you have been referred to us by another veterinarian, please provide their information below.
Pet Information 1


We would like to use your pet(s) photos and/or videos for fun things like Facebook, advertising, client education, etc.


Your scheduled appointment time is reserved just for you and your pet. We try not to overbook appointment times in order to provide excellent veterinary care and to be sure we have sufficient time to examine your pet and to discuss your pet’s condition and treatment options in detail with you.

We will make every effort to accommodate your scheduling needs. In return, we ask that you help us by keeping your scheduled appointments, arriving on time and notifying us a minimum of twenty-four (24) hours in advance if you are unable to do so. When we receive advanced notice of cancellation, we are able to accommodate other patients needing our care. If you miss your appointment the following will apply:

• First and Second missed appointment: Our staff will call to ensure you and your pet are all right and to reschedule your appointment.

• Third missed appointment: You will receive a letter stating this is your third missed appointment and that you have been charged a missed appointment fee ($25.00).


I hereby state that I am the owner, and/or the authorized agent for the owner, and have permission to make all decisions pertaining to the above pet(s). PROFESSIONAL FEES ARE DUE AT THE TIME OF SERVICES RENDERED. We will gladly prepare a written estimate if you desire. Please ask the receptionist, technician, or doctor.