New Patient Form

New Patient Form 2020-07-07T03:21:47+00:00

New Patient Form

**Email correspondence is used to remind you of scheduled appointments and when services are due (ie: annual exam, vaccines)

Required to dispense medication

FULL PAYMENT IS DUE AT THE TIME OF SERVICES - WE DO NOT ACCEPT PARTIAL PAYMENTS.

We accept CASH, DEBIT, AMERICAN EXPRESS, DISCOVER, MASTERCARD, VISA, and CARE CREDIT. Should your account become delinquent and you are sent to collections, you will be responsible for all collection fees.

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 below authorizes this level of preventative care and the appropriate charges will be assessed in the discharge invoice. If you have any questions regarding this, please ask the receptionist.

Pet #1

DogCat

Pet #2

DogCat

Pet #3

DogCat

Pet #4

DogCat