Get Acquainted/New Patient Form

Client Information
Street Address
Mailing Address (if different from street address)
I have reviewed the following information. I have updated any incorrect information, and agree this is now correct.
Patient (Pet) Information
I give my permission to share my pet’s medical records/information with the following (check all that apply):
Marketing
How did you hear about us?

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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