New Client Form

We thank you for giving us the opportunity to care for your pet. In order for us to meet your needs better, please take a moment to fill out the following form.

 

CLIENT INFORMATION

We will only use your e-mail address to send out vaccination reminders.

Best time of day to be contacted

CO-OWNER INFORMATION

PET INFORMATION

Tell us about your pet(s): *

 
Name
 
Species
 
Breed
 
Colour
 
DOB/Age
 


Sex
 
 1. 
 2. 
 3.
 4.
 5.
 

HOSPITAL POLICY

 

Please read the following and sign below indicating you understand our hospital policies.

 

Disease Prevention
In order to prevent the spread of infectious disease and parasites, hospitalized patients (grooming/surgery/medical work up) MUST be up to date on all core vaccinations and free of internal and external parasites. In the event that a hospitalized patient is found to be carrying parasites of any kind, the pet will be treated immediately and the owner will be responsible for the cost of treatment.

 

Payment for Services Rendered
Payment for services rendered is due upon discharge of the patient. An estimate will be provided, but it is an estimate not a 'quote'.

 

Method of Payment
Elmvale Veterinary Hospital can take payment in the form of Cash, Debit Cards, Visa and MasterCard only.

 

Medical Records
As per the College of Veterinarians of Ontario, medical records (including radiographs) are the property of the veterinary clinic and are to be maintained in the clinic for 5 years. Should you wish to have your files forwarded to another veterinary clinic due to a more or referral, we would be happy to send copies of the records to the facility. Radiographs can have copied mage, costs incurred will be the responsibility of the pet owner.

 

By signing below, you are confirming that you have read and understood the above hospital policies.

 

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