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New Client Registration Form
New Client Registration Form
10307 Alexandria Pike, Alexandria, KY 41001 - (859) 635-4138
Grants Lick AH - New Client Form
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    Welcome to our hospital. We look forward to serving you and your pet. Our office hours are Monday, Tuesday, Wednesday, and Thursday 8:00 AM-7:00 PM, Friday 8:00 AM-6:00 PM, and Saturday 8:00 AM-2:00 PM. At times, it may be necessary to close the office early due to staff meetings, Doctor continuing education, or inclement weather.  We do try to post this information ahead of time. 

    APPOINTMENT POLICY:
    Appointments are seen by appointment only. Appointments are seen by appointment time, not arrival time. If you can not keep your appointment, please call ahead to cancel. We reserve the right to require pre-payment for future visits in cases of prior missed appointments. All clients must stay on hospital grounds unless otherwise approved, in case the doctor needs to discuss patient’s care. Failure to do so will result in pet not being able to be seen.

    PRESCRIPTION OR FOOD REFILL POLICY:
    We ask that you call 24-48 hours ahead for all prescription refills and prescription pet foods. This ensures our staff is able to serve you in a timely manner. Our goal is to have records pulled, charted, and prescriptions or pet food ready when you arrive. Also, due to limited space, we are not able to carry a large supply of prescription pet foods. We place weekly orders, so remember it is always a good idea to call ahead for all prescription pet foods.

    PET MEDICAL RECORDS POLICY:
    In accordance with the Veterinary Practice Act regarding the confidentiality of Patient Medical Records, a written authorization executed by the client is required in order for our clinic to release copies of your pet’s medical records. Grant’s Lick and Pendleton County Veterinary hospital will release pet records without authorization to the following: Police Department, Health Department, Dog Wardens, Animal Shelters, callers with Rabies Tag Numbers. For the convenience of our clients and in order to avoid last minute written authorizations, clients may sign today to give permission to release medical records for any pet to: grooming and boarding facilities, other Veterinary Clinics, Pet Adoption, Breeders, Rescue Groups, or any other request for Records. See page 2 to provide authorization.

    EMERGENCY POLICY:
    After regular business hours there are no doctors or staff on duty. All emergencies will be referred to a local Emergency Clinic. In case of an AFTER HOURS EMERGENCY, please call our office at 859.635.4138. An after hours message will give you further instructions to contact a local emergency clinic. 

    BILLING POLICY:
    Payment is expected when services are rendered. Due to the high cost of billing, it is our policy NOT TO EXTEND CREDIT for any routine office visits, vaccines, surgery, medicines, or pet food because we want to be able provide the best veterinary care at the lowest possible cost to you. Clients are required to leave a deposit on pets that need to be hospitalized. The person that brings the pet in will be held responsible for the bill. In case of an emergency, if full payment cannot be made, all charges must be prior approved by management. Any balance remaining after 30 days is subject to a monthly service charge of $4 or 1.5% of balance, whichever is greater. Balance can be subject to fees up to a maximum of 32% of the debt. Service charges or billing charges may change without notice. We accept cash, checks, Visa, Discover, MasterCard, American Express, and Care Credit. THERE IS A $50.00 CHARGE ON ALL RETURNED CHECKS.

    Grants Lick Veterinary Doctors and Staff thank you for entrusting us with your pet’s health care.

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    Pet(s) Medical Record Release Policy

    In accordance with the veterinary practice act, regarding the confidentiality of patient medical records, a written authorization executed by the client is required in order for our clinic to release copies of your pet’s medical records. Grant’s Lick and Pendleton County Veterinary hospital will release pet records without authorization to the following: Police Department, Health Department, Dog Wardens, Animal Shelters, and callers with Rabies Tag Numbers.

    For the convenience of our clients and in order to avoid last minute written authorizations, clients may sign today to give permission to release medical records for any pet to a grooming or boarding facility, other veterinary clinic, and/or pet adoption/breeder/rescue groups.

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    Social Media Release Policy

    GLVH/PCVH occasionally uses information from patients for our social media pages, or website. Please indicate your consent (or lack thereof) below to such use of your pet’s information.

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    By signing below I agree I have read and understand polices of Grants Lick and Pendleton County Veterinary Hospitals stated on the reverse of this paper.
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