New Client Form

    My contact preference is


    You emergency contact is authorized to pick up and/or approve treatments for the pets on your account

    The Emergency Contact is a/an

    We may offer treats during the appointment, does any person attending appointments have any allergies, such as nut allergies, that we should be aware of?

    Pet Information


    Are they male or female?

    Are they neutered/spayed?

    Are they on any medications?

    Do they have any known allergies, to vaccines or otherwise?

    If you'd like us to add a photo of your pet to your account please attach one here.

    How did you hear about us?

    Social Media Consent


    We do not provide payment plans, but we do accept Care Credit and Scratch Pay for veterinary services.

    Methods of payment accepted: Cash, Check (except for the initial visit), Visa, Mastercard, Discover, American Express, Care Credit, and Scratch Pay.

    I understand that in order to meet certain scheduling requirements, all missed appointments will be considered a “no-show” after 20 minutes unless advance notice is arranged. Clients not appearing for appointments may be assessed up to $43.00 per incident. I understand every effort will be made to achieve a successful outcome and to provide for all possible safety in hospital care and handling. I hereby authorize this hospital to receive, prescribe for, treat or perform surgery upon the pet(s) listed above. Furthermore, I agree to pay fees for all services rendered at the time the pet is discharged from the hospital or the service is otherwise terminated. I agree to pay for the reasonable costs of collection, attorney fees, and court costs in the event that collection efforts become necessary. I agree that the venue of this action will be in the county where the hospital is located. I understand that veterinary service is provided during nighttime hours as necessary in the judgment of the veterinarian in charge. Continuous presence of qualified personnel may not be provided.

    Owner Signature: