Zionsville Animal Hospital Registration Form

Pet Information

Please sign below if you agree:

I authorize Zionsville Animal Hospital to take photos of my pet(s) to use for promotional and/or social media.

If you do not authorize for us to use photos of your pet(s) please write do not agree in the signature line.
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*Please note that your privacy is important to us. All information received in all forms and through other communication is subject to our Patient Privacy Policy. I authorize the doctors and staff of Zionsville Animal Hospital to provide medical service to my pet(s) and I assume full financial responsibility for those services. Any fees associated with an overdue account, such as collection agency fees, attorney fees or court costs, as well as any charges for a refund check will be the responsibility of the client. I have read and understood the above statements and agree to all terms therein.
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