New Client Form

  • New Client Form

    This form consists of five parts and will be used to collect information needed by the staff at Heather Ridge Pet Hospital to provide you and your pet(s) with the best care. During your first visit, we will confirm this information with you.
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  • Pet Birthdate, if known
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  • Do you have other pets in your household?*
  • At Heather Ridge Pet Hospital, we treat all of our patients with care and respect. When possible, minimal restraint is used and treats are liberally given, when medically appropriate, to aide in keeping animal stress low. This MAY include products containing peanut better. Please select one of the following:*

  • Section 2/5

    This section of the form will ask you questions about your pet's diet.
  • My pet's diet consists of (check all that apply):*
  • My pet's food is available:*

  • Section 3/5

    This section will ask you about you pet's medications, including heartworm and flea/tick prevention.
  • Is your pet currently taking any medications? (Including heartworm and flea/tick prevention, and any supplements)*
  • My pet is on heartworm prevention:*
  • My pet is on flea/tick prevention:*

  • Section 4/5

    This section will ask you about wellness and preventative care.
  • Microchip*
  • Oral Health (select all that apply)*
  • Rabies vaccine*
  • Can we contact your previous veterinarian to obtain medical records? This will help to provide seamless care from one facility to another.*
  • Please check any health conditions your pet has been diagnosed with previously. Leave blank if your pet has never been diagnosed with a health condition before.
  • Please select the activities that your pet participates in:

  • Section 5/5

    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 and any other marketing and/or social media outlets we may choose to use?*
  • Heather Ridge Pet Hospital uses email, text, phone calls, and postcards for communications regarding our patient's reminders for health care needs. Please select all of the types of communication you would like to receive:*

  • 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). Our office also offers PawPlans for preventive care treatments and procedures. You can find more information about these at https://www.petonevet.com/pawplans/. In addition, we also offer several 3rd party financing options for our clients via Care Credit. We accept a variety of Care Credit plans based on the total transaction amount for your pet. 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. As financing options are offered, we cannot offer additional in-house payment plans for our services.  Clients needing additional financial support are encouraged to apply for Care Credit with a co-signer. 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 monthly finance charge on accounts over 30 days and any collection and/or legal fees on accounts over 90days. Your signature below indicates your agreement with these policies.        

  • Treatment Consent

    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 Heather Ridge Pet 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 or grooming facility. 
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