New Patient Form

New Client/Patient Information Sheet


PROFESSIONAL FEES ARE DUE AT THE TIME SERVICES ARE RENDERED.

ROBERTSDALE ANIMAL CLINIC IS A FLEA-FREE FACILITY. ALL PETS ENTERING THE KENNEL WILL BE GIVEN A $5.50 CAPSTAR AT THE OWNER'S EXPENSE.

TO PREVENT THE SPREAD OF INFECTIOUS DISEASES & PARASITES, HOSPITALIZED PETS MUST BE UP TO DATE ON THEIR RABIES VACCINE & FREE OF INTERNAL AND EXTERNAL PARASITES.

I assume responsibility for ALL charges in the care of my pet. I also understand that these charges will be paid at the time of release and that a deposit may be required for surgical treatment. I understand that if I do not pay as agreed, I agree to pay all costs for collection.