Affordable Pet Hospital Forms

New Client Form

New Client Form

Click on the form above to download and print or complete the below form online:

    All fees are due at time services are rendered

    Please indicate choice of payment *

    How did you become aware of our clinic? *

    If Other, please specify:

    ****PET 1****

    Heartworm/Flea Prevention *

    Sex: Spayed or Neutered? *

    ****PET 2****

    Heartworm/Flea Prevention

    Sex: Spayed or Neutered?

    ****PET 3****

    Heartworm/Flea Prevention

    Sex: Spayed or Neutered?

    PERSON TO CONTACT IN CASE OF AN EMERGENCY

    I accept the terms: *

    All fees are due and payable upon release of patient. If the patient has to be admitted for treatment, a deposit will be required at that time.

    "I give Affordable Pet Hospital permission to obtain my pet's medical records from other animal hospital's and also give my pets medical history to other veterinarians whenever necessary."