Devon Veterinary New Client Enrollment Form

  • Thank you for considering Devon Veterinary Hospital for your pet's needs. Please fill out our new client/patient registration form in entirety to ensure we can provide you and your pet with the best possible care.

  • THIS FORM IS NOT TO SCHEDULE AN APPOINTMENT

    Please call to schedule an appointment with one of our receptionists. 610-688-5224
  • Have you ever brought a pet to Devon Veterinary Hospital before?*
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  • How Would You Prefer To Be Contacted?*
  • Is There a Spouse/Partner/Family Member Who Should Be Listed On Your Account?
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  • In case of emergency...

  • Is there anyone else (besides above listed contacts) who should be listed on your account, who has ongoing permission to make medical decisions for your pet(s)?
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  • How did you hear about us?*
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  • Species*
  • Sex*
  • Is Your Pet Microchipped?*
  • Do You Already Have a Scheduled Appointment?*

  • PLEASE CALL TO MAKE AN APPOINTMENT

    This form is NOT an appointment request. You must call 610-688-5224 to make an appointment to be seen.
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  • Do You Have More Than One Pet At Home?
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  • Species*
  • Sex*
  • Is Your Pet Microchipped?*
  • Do you have more than 2 pets at home?
  • Browse Files
    Cancelof
  • Species*
  • Sex*
  • Is Your Pet Microchipped?*
  • Browse Files
    Cancelof
  • Species*
  • Sex*
  • Is Your Pet Microchipped?*

  • This form supports telling us about 4 pets in your home. If you have more than 4 pets, please let our office know and we will happily collect information to add them to your account. 

  • Client Policies and Procedures

    We want you to be aware of and understand the following policies and procedures for all clients.
  • We Love Social Media! Do we have your permission to post pictures of your pet(s), you and your pet(s) and/or your pet(s) and our team on Facebook, Instagram, Twitter, www.devonvet.com and any other marketing and/or other social media outlets we may choose to use?*
  • Devon Veterinary Hospital uses email, text and our own hospital app for communications regarding our patient's reminders for health care needs. Do we have your permission to contact you via email, text and/or our app regarding these reminders?*

  • FINANCIAL POLICY:

    Our office accepts Visa, Mastercard, Discover, and American Express. We also accept cash and checks (only with verification of valid drivers license or other ID at time of payment).

    In addition, we also offer several 3rd party financing options for our clients via Care Credit. Care Credit requires that payment only be made for services as they are rendered, we cannot charge services to your account in advance. Additionally, use of Care Credit requires that the card be present every time and that two forms of identification are verified. We appreciate your understanding of our desire to protect your account/identity.

    Full payment is due at the time of service. This includes any charges/fees agreed to by my authorized proxy. Our team is happy to provide any client with a written treatment plan prior to services being rendered. Client will be responsible for a 1.5% monthly finance charge on accounts over 30 days and any collection and/or legal fees on accounts over 90 days. Your signature below indicates your agreement with these policies.

  • TREATMENT CONSENT:

    By signing this document, I declare I am the lawful owner of all listed pets and all information is true and correct to the best of my knowledge. I hereby authorize the veterinarian(s) of Devon Veterinary Hospital to examine, prescribe for or treat the my pet(s) to the best of their abilities. I assume responsibility for all charges incurred in the care of this animal. I acknowledge that medical information will not be released to anyone not indicated on this form without my express verbal and/or written permission with the except of another veterinary facility.

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