Veterinary New Client Enrollment Form
Language
  • English (US)
  • Español

  • New Client Information

    Thank you for selecting Cascade Animal Clinic 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.

  • IMPORTANT:

    We require 24 hours or more notice to cancel or reschedule your appointment.
  • Please select how we can use your e-mail address:*

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  • Phone Location:*

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  • Phone Location:

  • How Would You Prefer To Be Contacted?*
  • Is There a Spouse/Partner/Family Member/Friend Who Should Be Listed On Your Account? **This person would have the same account authorization(s) as you.***
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  • Phone Location:

  • 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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  • Phone Location:

  • How did you hear about us?*

  • Due to a recent increase in bite occurrences to our staff and doctors, we are requiring ALL pets seen at Cascade Animal Clinic to be current on their Rabies vaccine, unless the doctor determines that it is not appropriate due to medical reasons.

    If proof of an up to date Rabies vaccine cannot be provided before your appointment date/time, one will need to be given when the patient is here.  

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  • Species*
  • Sex*
  • Is Your Pet Microchipped?*
  • Do You Already Have a Scheduled Appointment?*
  • Appointment Date
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  • May We Contact Them for Your Pet(s) Records?*

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  • Do You Have More Than One Pet At Home?
  • Browse Files
    Cancelof
  • Species*
  • Sex*
  • Is Your Pet Microchipped?*
  • May We Contact Them for Your Pet(s) Records?*

  • Browse Files
    Cancelof
  • Do you have more than 2 pets at home?
  • Browse Files
    Cancelof
  • Species*
  • Sex*
  • Is Your Pet Microchipped?*
  • May We Contact Them for Your Pet(s) Records?*

  • Do you have more than 3 pets at home?
  • Browse Files
    Cancelof
  • Species*
  • Sex*
  • Is Your Pet Microchipped?*
  • May We Contact Them for Your Pet(s) Records?*

  • 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.cascadeanimalclinic.com, and any other marketing and/or other social media outlets we may choose to use?*

  • FINANCIAL POLICY:

    Our office accepts Visa, Mastercard, Discover, American Express, Apple Pay, and Android Pay. 

    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.

    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.

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