New Patient Form

We are still utilizing curbside services and ask for your patience as certain tasks may take longer than you are used to. Please view the appointment protocol here.

    Please fill out one form per pet. The following requirements must be met before an appointment can be scheduled:

    1) New client form must be completed and returned
    2) Cancellation Policy must be signed and returned
    3) Previous medical records must be emailed/faxed

    Pet Information:
    We are frequently asked about the prices of our services. Charges vary based on the type of care needed by your pet. Please ask for specifics when discussing treatment recommendations with your pet’s doctor. While our hospital does not offer in-house payment plans, we do accept all forms of payments. All charges are due at the time of service. We accept Care Credit for transactions over $200.

    I am the owner (or authorized agent for the owner) of the pet named above and authorize Medical Veterinary Service (“MVS”), its veterinarians, technicians, and assistants to perform services, procedures, diagnostics, vaccinations, treatments, and/or administration of medications as deemed necessary or advisable in connection with or relating to the matters described in the attached estimate or the matters that have otherwise been explained by the MVS veterinarian or other employee. I understand there is a risk of complications with every procedure, including the possibility of death as a severe complication of surgery, anesthesia, or other procedures. I also understand that there is no guarantee as to the results of any procedures, diagnostics, vaccinations, or treatments. I understand that I may ask questions regarding any procedure, diagnostic, vaccination, or treatment recommended by the MVS veterinarian before it is performed. I understand that a veterinarian may not be present at the hospital at certain times and that veterinary technicians or assistants may perform certain functions in the preparation and care of my pet even when a veterinarian is not present. I also understand that no staff will be present in the hospital overnight. Unless the veterinarian advised that my pet may remain unattended in the hospital overnight, I will need to take my pet home or transfer my pet to a hospital offering overnight care at the end of the day. If I fail to pick up my pet before the hospital closes for the day, MVS may transfer my pet to a hospital offering overnight care if the veterinarian determines that my pet cannot be left unattended overnight. I understand and agree that I am responsible for the payment of any charges for such overnight care. I agree that hospital staff may walk my pet outside. I understand in the event of an emergency, it may be necessary for my pet to be taken to an emergency hospital. I authorize MVS and its veterinarians and other personnel to transport my pet to an emergency hospital and to obtain treatment by the emergency hospital to stabilize my pet if I cannot be reached. MVS and its personnel may disclose such information and records regarding my pet to the other hospital as they consider necessary. If I neglect to pick up my pet within 7 days, MVS may assume that my pet has been abandoned and is authorized to make such arrangements as it may deem best. I understand that payment is due, in full at the time services are rendered. If for any reason payment is not made at the time services are rendered or within 7 days thereafter, I understand that my account may be referred to a collection agency. In the event that my account is referred to a collection agency, I agree that MVS may add an amount to my outstanding account balance to reimburse MVS for the reasonable collection charge (but not including attorney’s fees) imposed by the collection agency.

     

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