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Ahi - Cares  - New Client/Patient Information Form
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    New Client/Patient Information Form

    Thank You for giving our hospital the opportunity to care for your pet. So that we may be better able to meet your needs, please complete the following:

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    Please Select
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    • Internet Search
    • Drive by
    • Website
    • Local Area Vet
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    #1
    • Male
    • Male Neutered
    • Female
    • Female Spayed
    • Unknown
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    #2
    • Male
    • Male Neutered
    • Female
    • Female Spayed
    • Unknown
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    #3
    • Male
    • Male Neutered
    • Female
    • Female Spayed
    • Unknown
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    • No
    • Yes
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    Payment Policy:
    Full payment is required upon rendering of services. We do not carry charge accounts. Deposits are required for all major medical/surgical procedures. We will provide you with a written statement of fees at your request. We accept cash, checks, Mastercard, Discover & Visa.

    I have read the above and understand Animal Hospital Inc/ Hillcrest Animal Hospital’s Payment Policy.

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    Clear
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    Pick a Date
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    Thank you for bringing your pet(s) to our hospital(s). We hope you are pleased with our services and facilities and would appreciate if you would let us know how we might improve them.

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