New Client Enrollment Form

  • Thank you for considering Warrenville Grove Animal 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.
  • Have you ever brought a pet to Warrenville Grove Animal 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?*
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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 another pet 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.
  • 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, in clinic TV, and any other marketing and/or other social media outlets we may choose to use? *

  • 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 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 a photo ID that matches the name on the card. We appreciate your understanding 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. Your signature below indicates your agreement with these policies.

  • Warrenville Grove Animal 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? *

  • 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 Warrenville Grove Animal Hospital to examine, prescribe for or treat 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 exception of another veterinary, boarding, grooming and or adoption facilities. (unless otherwise noted by you.)

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