WELCOME TO HOOD RIVER ALPINE VETERINARY HOSPITAL Logo
  • WELCOME TO HOOD RIVER ALPINE VETERINARY HOSPITAL

    We are pleased to welcome you to our practice. Please take a few minutes to fill out this form as best you can. If you have any questions we will be happy to assist you. We look forward to working with you in maintaining your pets health.
  • CLIENT INFORMATION

  •  -
  •  -
  • PAYMENT IS REQUIRED AT THE TIME SERVICE IS RENDERED OR WHEN THE PATIENT IS RELEASED. WE ACCEPT CASH, CHECK, VISA, MASTERCARD, DISCOVER, AMERICAN EXPRESS, CARE CREDIT OR SCRATCHPAY.

  • Clear
  •  / /
  • If under 18 years of age we must have parent or guardian’s authorization.

    If you leave your pets in the care of other person we have an alternate form for authorization of care.

  • Electronic Communication Consent Form

  • I consent that Alpine Veterinary Hospital can provide their services and communicate with me via mobile phone, messages, e-mail and any kind of online communications, provided that these communications comply with privacy regulations.

    Appointment Reminders, Reschedules and Cancellations

    I understand that Alpine Veterinary Hospital can reach me any time to remind me of my appointments or let me know in case of any change about my appointments. I also understand that Alpine Veterinary Hospital can employ and use a third-party automated system to reach out me for the purpose of "confirm", "reschedule" or "cancel".

    Telemedicine Appointments

    For telemedicine, I understand the appointments will be held via electronic environments.

    Contact Information Change

    I accept that I am responsible of notifying the Company when my contact information change.

    Consent Cancellations

    I know that I can revoke this consent at any time by contacting the Company.

  •  - -
  • Clear
  • Should be Empty: