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Home
About
Services
Contact
New Client form
Owner information
Owner name:
Spouse/ Partner:
Address:
Phone:
Email
Emergency contact#:
Animal Information
Pet Name:
Age (approximate)
Type:
Breed:
Sex:
Male
Female
Color:
Neutered/spayed?
Yes
No
Current medications pet is taking:
Primary reason for visit
Do we have permission to use photos and/or video footage of your pet:
On our website?
Yes
No
On our social media accounts?
Yes
No
How did you hear about us?
Online search
Social Media
Word of mouth
Drove by
Other
Cancellation/Rescheduling Policy for SURGERY
If you are unable to keep a scheduled office visit appointment, please give 24 hours advance notice to avoid being charged a $50.00 fee. I have read and understand these policies.
Cancellation/Rescheduling Policy for OFFICE VISITS
If you are unable to keep a scheduled office visit appointment, please give 24 hours advance notice to avoid being charged a $50.00 fee. I have read and understand these policies.
Authorization
I hereby authorize the veterinarian to examine, prescribe for, or treat the above-described pet. I assume responsibility for all charges incurred in the care of the animal. I also understand that all professional fees are due at the time services and rendered and that a deposit may be required for certain surgical treatments or other procedures. I have read and understand the above policies.
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