New Pet Patient Registration Form

Thank you for giving us the opportunity to care for your pet!
Please complete the following information so that we may become better acquainted.

Choose Your Location

Client/Owner Information

Pet Information

How did you hear about our hospital?

Medical Release Consent and Social Media Consent (Please initial below)

Payment Policy

Payment is due at the time of service. This policy help control costs on which we base our fees. A 50% deposit may be required for day admission cases and procedures, including, but not limited to: Surgery, Dentistry, and hospitalization. We accept cash, check, credit, debit, and Care Credit. We do not carry open accounts and hope the above alternatives are convenient for you.

Financial Agreement and Authorization

I hereby authorize the veterinarian and staff at Vitality Veterinary Services to examine, prescribe for, and treat my animal. I assume responsibility for all charges incurred in the care of my animal. I agree to pay any costs and chares necessary for the collection of any amount not paid when due.