Get Acquainted/New Patient Form

Client Information
Street Address
Mailing Address (if different from street address)
Patient (Pet) Information
I give my permission to share my pet’s medical records/information with the following (check all that apply):
I hereby grant Creekside Animal Hospital & Wellness Center permission to use my pet or my pets likeness in photographs/videos in any and all of its publications and in any and all other media, where now known or hereafter existing. I will make no monetary or other claim against Creekside Animal Hospital & Wellness Center for their use.
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Terms and Conditions

  • Payment is due when services are rendered.
  • Creekside Animal Hospital and Wellness Center reserve the right to assess collection and/or attorney fees associated with non-payment.
  • The client agrees to pay any and all court/attorney fees necessary to enforce this agreement

I hereby authorize the veterinarian to examine, prescribe for or treat the above-described pet(s). I assume responsibility for all charges incurred in the care of this animal. I also understand that these charges must be paid in full, at the time of release of the pet.

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