New Client Registration Form

New Client Registration Form
Please note: We must receive your pet's records from your previous veterinarian before we can schedule your pet's appointment. Records can be emailed to mail@ovillavet.com, faxed to 972-617-5559, or hand-delivered to our office.

Also, be aware that we require a non-refundable deposit equal to the exam fee in order to secure your appointment slot. We will take the deposit over the phone when we schedule your appointment. If you cancel the appointment and don't reschedule within 60 days, your deposit will expire.

We look forward to meeting you and caring for your furry family member!
Your full name *

First Name Last Name
Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Physical Address, if different

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Primary Phone Number *

Area Code Phone Number
Secondary Phone Number

Area Code Phone Number
E-mail *
Driver's License Number and State
Date of Birth

Month Day Year
Date
Spouse or Co-Owner's Name

First Name Last Name
Spouse or Co-Owner's Phone Number

Area Code Phone Number
Previous Vet *
Previous Vet Phone Number

Area Code Phone Number
Place of Employment
Name
Employer's Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Employer's Phone Number

Area Code Phone Number
Emergency Contact Name

First Name Last Name
Emergency Contact Phone Number

Area Code Phone Number
Pet #1: Name *
Species *
Date of Birth *

Month Day Year
Date
Breed *
Color/Markings *
Gender *

Male Female
Spayed/Neutered? *

Yes No
Do you want to register a second pet? *

Yes No

Pet #2
Pet #2: Name *
Species *
Date of Birth *

Month Day Year
Date
Breed *
Color/Markings *
Gender *

Male Female
Spayed/Neutered? *

Yes No
Do you want to register a third pet? *

Yes No

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Pet #3
Pet #3: Name *
Species *
Date of Birth *

Month Day Year
Date
Breed *
Color/Markings *
Gender *

Male Female
Spayed/Neutered? *

Yes No
Do you want to register a fourth pet? *

Yes No

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Pet #4
Pet #4 Name *
Species *
Date of Birth *

Month Day Year
Date
Breed *
Color/Markings *
Gender *

Male Female
Spayed/Neutered? *

Yes No
Do you want to register a fifth pet? *

Yes No

Pet #4 section collapse stopper

Pet #5
Pet #5 Name *
Species *
Date of Birth *

Month Day Year
Date
Breed *
Color/Markings *
Gender *

Male Female
Spayed/Neutered? *

Yes No
If you have more than 5 pets, please email the other pets' information to mail@ovillavet.com.

Pet #5 section collapse stopper
How did you hear about us? *
Other *
Referring Person *
Policies and Consents
We're guessing your pet is pretty cute. May we use photos of your pet(s) on our website and in our social media? *

Yes No
Appointments must be cancelled or rescheduled at least 24 hours before the scheduled time.
- There is a $25/pet fee if you do not show up for an appointment (or, if you made a deposit, your deposit is forfeited).
- There is a $25/pet fee for a cancellation less than 24 hours before your appointment (or, if you made a deposit, your deposit is forfeited).
- Any no-show/cancellation charges assessed to your account must be paid prior to any subsequent visits.
- If you repeatedly miss appointments, we may require a deposit before scheduling a new appointment.
Please initial to indicate this cancellation policy is understood. *
I understand that a non-refundable deposit equal to the exam fee is required in order to secure my appointment slot. I understand that, if I cancel with less than 24 business hours notice, I will forfeit my deposit. I understand that, if I cancel the appointment and don't reschedule within 60 days, my deposit will expire.
Please initial to indicate this deposit policy is understood. *
Full payment is due at the time services are rendered.
- If treatment will require hospitalization, a deposit will be required.
- If for some reason full payment is not made at the time services are provided, there is a $5 or 1.5% monthly service charge (whichever is greater).
- If the account is not paid after 3 months, it will be sent to a collection agency and charged an additional $30 fee.
Please initial to indicate this payment policy is understood. *
Full payment must be made at the time services are provided. Payment methods:
- We accept cash, debit/credit cards, and Care Credit.
- Checks are not accepted until the client is well-established.
- There is a $30 charge for all returned checks.
Please initial to indicate this payment method policy is understood. *
I understand that the use of some medications in the treatment of my animal constitutes “off label” use. This is defined as “actual or intended use of a drug in a manner that is not in accordance with the approved labeling” and in this instance describes use either in a species not listed on the labeling or for indications not listed on the labeling. Many human-approved drugs are commonly used in veterinary medicine even though they have not been approved in veterinary patients, because no species-specific approved product is available. Some medications have been approved for one species but not yet for another; again, they are often used for non-approved species because no species-specific product is available. AHO doctors only use non-approved products when anecdotal or empirical evidence has shown no danger.

Animal Hospital of Ovilla is to use all reasonable precautions against injury of my pet, but will not be held liable or responsible in any manner in connection therewith as it is thoroughly understood that I assume all risks.
Please initial to indicate this liability policy is understood. *
I give permission and/or informed consent for the direct exchange of medical information with the AHO staff via telemdicine (including telephone, apps, video calls, email, and texting). I understand that the laws that protect privacy and the confidentiality of medical information also apply to telemedicine, and that no information obtained in the use of telemedicine which identifies me will be disclosed to other entities without my consent.
Please initial to indicate this telemedicine policy is understood. *
I hereby authorize the veterinarian to examine, prescribe for, or treat the above described pet(s). I understand that no guarantee or assurance can be made as to the results that may be obtained. It is thoroughly understood that I assume all risks involved with any treatments, surgeries, or procedures. I assume responsibility for all charges incurred in the care of this/these animal(s).
Signature of Owner (use mouse, finger, or stylus) indicating authorization *

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New Client Registration Form

Policies and Consents