New Patient Form

New Clients can either complete the form below in its entirety and submit to us electronically, or download the New Patient Form, print and complete and bring with you to your scheduled appointment .

If you have multiple pets - a New Patient Form needs to be filled out and submitted for each pet.  After filling out a form for one pet, click on the "Submit" button and then choose New Patient Form from the menu again and fill out a new form for the next pet.  The "Submit" button must be clicked at the end of each pet's form - do not hit the back button.

The Village Vets Location
Client Information
Pet Information
Health Information

Pets are required to be current on vaccinations for boarding and all
drop-off procedures.  Exams are required for, and are a separate charge
with annual vaccinations.

Signature

I hereby assume full and complete responsibility for the charges that may occur during the examination and/or treatment.  I also understand that Payment is due in full on completion of examination or patient discharge. Furthermore, I do understand that if my animal is ill and/or hospitalized, a deposit may be required.

We gladly accept Visa, Mastercard, American Express and Cash.

WE DO NOT ACCEPT PERSONAL CHECKS FROM NEW CLIENTS.

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