New Client Form

New Client Form

Client Information

Thank you for giving us the opportunity to care for your pet(s). Please help us to better meet your needs by taking a moment to complete both pages of this information sheet.

Primary Owner Information

Name
Name
First
Last
Address
Address
City
State/Province
Zip/Postal
How may we contact you for appointment reminders, general inquiries, visit summaries, etc.?

Secondary / Alternate Owner Information

Name
Name
First
Last
How did you hear about us?

TO PREVENT THE SPREAD OF INFECTIOUS DISEASES AND PARASITES, ANIMALS HERE FOR BOARDING, BATHS, AND NON-SICK VISIT DROP-OFF APPOINTMENTS MUST BE CURRENT ON ALL REQUIRED VACCINATIONS AND FREE OF INTERNAL / EXTERNAL PARASITES. HOSPITALIZED AND / OR SICK VISIT DROP-OFF APPOINTMENTS WILL BE EVALUATED BY A DOCTOR PRIOR TO ANY VACCINATION(S) BEING ADMINISTERED.

PAYMENT IS DUE AT THE TIME SERVICES ARE RENDERED. We accept all major credit / debit cards, cash, and Care Credit. In order to abide by Care Credit guidelines, this method may only be used if the individual whose name is on the card is present at the time of the transaction. We will gladly prepare an estimate if you would like, just ask a staff member or doctor.

Carefully read and select AT LEAST one of the following:
Who's signature?