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Chico Animal Hospital -   New Client Form

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    Welcome

    We are pleased to welcome you to our practice! Please take a few minutes to review our policies and fill out our new client form as completely as you can. If you have questions, we are happy to help you. We look forward to working with you in maintaining your pet’s health!

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    • Afghanistan
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    • Angola
    • Anguilla
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    • Australia
    • Austria
    • Azerbaijan
    • The Bahamas
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    • Bangladesh
    • Barbados
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    • Belgium
    • Belize
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    • Cambodia
    • Cameroon
    • Canada
    • Cape Verde
    • Cayman Islands
    • Central African Republic
    • Chad
    • Chile
    • China
    • Christmas Island
    • Cocos (Keeling) Islands
    • Colombia
    • Comoros
    • Congo
    • Cook Islands
    • Costa Rica
    • Cote d'Ivoire
    • Croatia
    • Cuba
    • Curaçao
    • Cyprus
    • Czech Republic
    • Democratic Republic of the Congo
    • Denmark
    • Djibouti
    • Dominica
    • Dominican Republic
    • Ecuador
    • Egypt
    • El Salvador
    • Equatorial Guinea
    • Eritrea
    • Estonia
    • Ethiopia
    • Falkland Islands
    • Faroe Islands
    • Fiji
    • Finland
    • France
    • French Polynesia
    • Gabon
    • The Gambia
    • Georgia
    • Germany
    • Ghana
    • Gibraltar
    • Greece
    • Greenland
    • Grenada
    • Guadeloupe
    • Guam
    • Guatemala
    • Guernsey
    • Guinea
    • Guinea-Bissau
    • Guyana
    • Haiti
    • Honduras
    • Hong Kong
    • Hungary
    • Iceland
    • India
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    • Ireland
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    • Kazakhstan
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    • Latvia
    • Lebanon
    • Lesotho
    • Liberia
    • Libya
    • Liechtenstein
    • Lithuania
    • Luxembourg
    • Macau
    • Macedonia
    • Madagascar
    • Malawi
    • Malaysia
    • Maldives
    • Mali
    • Malta
    • Marshall Islands
    • Martinique
    • Mauritania
    • Mauritius
    • Mayotte
    • Mexico
    • Micronesia
    • Moldova
    • Monaco
    • Mongolia
    • Montenegro
    • Montserrat
    • Morocco
    • Mozambique
    • Myanmar
    • Nagorno-Karabakh
    • Namibia
    • Nauru
    • Nepal
    • Netherlands
    • Netherlands Antilles
    • New Caledonia
    • New Zealand
    • Nicaragua
    • Niger
    • Nigeria
    • Niue
    • Norfolk Island
    • Turkish Republic of Northern Cyprus
    • Northern Mariana
    • Norway
    • Oman
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    • Palau
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    • Paraguay
    • Peru
    • Philippines
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    • Poland
    • Portugal
    • Puerto Rico
    • Qatar
    • Republic of the Congo
    • Romania
    • Russia
    • Rwanda
    • Saint Barthelemy
    • Saint Helena
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    • Saint Lucia
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    • Samoa
    • San Marino
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    • Saudi Arabia
    • Senegal
    • Serbia
    • Seychelles
    • Sierra Leone
    • Singapore
    • Slovakia
    • Slovenia
    • Solomon Islands
    • Somalia
    • Somaliland
    • South Africa
    • South Ossetia
    • South Sudan
    • Spain
    • Sri Lanka
    • Sudan
    • Suriname
    • Svalbard
    • eSwatini
    • Sweden
    • Switzerland
    • Syria
    • Taiwan
    • Tajikistan
    • Tanzania
    • Thailand
    • Timor-Leste
    • Togo
    • Tokelau
    • Tonga
    • Transnistria Pridnestrovie
    • Trinidad and Tobago
    • Tristan da Cunha
    • Tunisia
    • Turkey
    • Turkmenistan
    • Turks and Caicos Islands
    • Tuvalu
    • Uganda
    • Ukraine
    • United Arab Emirates
    • United Kingdom
    • United States
    • Uruguay
    • Uzbekistan
    • Vanuatu
    • Vatican City
    • Venezuela
    • Vietnam
    • British Virgin Islands
    • Isle of Man
    • US Virgin Islands
    • Wallis and Futuna
    • Western Sahara
    • Yemen
    • Zambia
    • Zimbabwe
    • Other
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    • Google
    • Location
    • Internet
    • Other
    • Yellow Pages
    • Yelp
    • Veterinarian
    • Person
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    Please Select
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    • Dog
    • Cat
    • Rabbit
    • Rat
    • Guinea Pig
    • Hamster
    • Mouse
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    • Female
    • Female/Spayed
    • Male
    • Male/Neutered
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    • Yes
    • No
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    • Early Morning
    • Late Morning
    • Early Afternoon
    • Late Afternoon
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    • Early Morning
    • Late Morning
    • Early Afternoon
    • Late Afternoon
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    Please Select
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    • Early Morning
    • Late Morning
    • Early Afternoon
    • Late Afternoon
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    By selecting yes, you consent to allowing Chico Animal Hospital to use your pet's image for media/public use.
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    Appointment Information

    A non-refundable deposit will be processed when scheduling your first appointment. This will be applied as a credit to your first appointment.

    The deposit will be forfeited and will not be applied as a credit if you:

    • Do not attend your appointment,
    • Cancel or reschedule within 24 hours of the appointment time,
    • Are late by more than half the appointment time period regardless of rescheduling or examination completion.

    All canine and feline patients are required to have a current Rabies vaccination, with the exception of patients who have documented medical exemption stating otherwise.

    Examinations may be recorded for medical record generation and training purposes.

    Please allow up to 7 business days for a staff member to reach out to schedule your appointment.

    If your pet is experiencing a medical emergency, please call us at 530-342-0518 or contact VCA Valley Oak at 530-342-7387 for after hours assistance.

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    Forms of Payment

    We accept Cash, Amex, Visa, MasterCard, Discover, Debit, Apple Pay, Google Pay & Care Credit.

    All professional fees are due at the time service is rendered. In cases of extensive medical or surgical procedures, a pre payment may be required.

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    Signature of client responsible for pets or duly authorized agent (you must be over the age of 18 to sign as the responsible party for your pet).
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