New Client Form

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Thank you for giving the team at Glendale Animal Hospital the opportunity to care for your pet(s). So that we may become better acquainted, please complete the following New Client Form before your first appointment

 

  • PET'S NAMEBREEDAGE / DATE OF BIRTHCOLOR / MARKINGSSEX; SPAYED OR NEUTERED? 
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  • All fees are due at the time services are rendered.
  • If you have additional pets please fill out the following:
  • PET'S NAMEBREEDAGE / DATE OF BIRTHCOLOR / MARKINGSSEX; SPAYED OR NEUTERED?DOG: VACCINATION HISTORY RABIES 
    Add a new row
  • PET'S NAMEBREEDAGE / DATE OF BIRTHCOLOR / MARKINGSSEX; SPAYED OR NEUTERED? 
    Add a new row
  • Please Read I understand, by indicating I agree and submitting this registration, that I am responsible for any charges incurred by my pet while in the care of the doctors at Glendale Animal Hospital and that charges are due and payable at the time of service, unless other arrangements are made in advance. Any balance that is carried over a period of 30 days will accrue a monthly finance charge of 1.5% or 18% per annum. Any balance that I leave unpaid will be forwarded to Glendale Animal Hospital's collection agency, and will incur a 25% collection fee for which I am liable, in addition to monthly finance charges.
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