New Patient Form

Fields with an asterisk must be filled in.

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

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

    Required to dispense medication

    Pet #1

    DogCat

    Pet #2

    DogCat

    Pet #3

    DogCat

    Pet #4

    DogCat

    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.

    If you or anyone you know have been experiencing symptoms or have been exposed to Covid-19 please inform us and we will work to reschedule your appointment. Thank you.