Client Information

Mrs. Mr. Ms. Dr.

Method of payment today

Payment is required at the time of service. For your convenience, we accept Mastercard, Visa, American Express, cash, or check (with a valid driver’s license).

Cash Check Debit/Credit

How much information do you want to be given about your pet’s health?

I want a full explanation—anything and everything. I want a brief explanation—just the important stuff. I just want to know if there’s anything I need to do—keep it simple.


You will be asked to sign a health plan confirming authorization of treatment after a tentative diagnosis. The details of treatment, the risks of treatment, and/or the risk of not treating will be explained to you.

Pet Information

Male Female
Yes No
Yes No
Yes No