New Client Registration Form

New Client Registration Form

Thank you for choosing White Oaks Veterinary Hospital. We are excited to meet you and your pet! Our primary mission is to deliver the best and most comprehensive veterinary care available. Please take a few minutes to provide us with some information so we can get to know you and your pet.
Primary Account Owner*

First NameLast Name
Mobile Number*
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Email Address*
example@example.com
Secondary Owner
First and Last Name
Secondary Owner Number
Please enter a valid phone number.Format: (000) 000-0000.
How did you hear about us?
Who can we thank for the referral?
First and Last Name of referring client
Based on the recommendation of a friend/family member.I spoke with a team member who was friendly and knowledgeable.You are close to my home/easy to get to.Your hours are convenient for my schedule.I was able to get an appointment easily.Other
Pet Information*
Who was your previous vet?*
Please have them email your records to wovhrecords@gmail.com Enter n/a if it's their first time at the vet.
Please read the following policies carefully before signing.

Financial Policy

White Oaks Veterinary Hospital requires payment at the time that services are rendered. We accept cash, check, Visa, Mastercard, Discover, and CareCredit. If you have any questions, please do not hesitate to ask. We are here to provide you with the best veterinary care available. White Oaks Veterinary Hospital reserves the right to refuse further services to any account with an outstanding balance.

Appointment No-Show Policy

When clients forget to cancel an appointment or cancel with very little notice, we miss the opportunity to fill that appointment time and help another pet in need. All scheduled appointments receive reminders by email, text, and/or phone call, depending on the contact method(s) provided to us by the client.

For a first time “no-show”, the client will receive a copy of our Appointment No-Show Policy and an alert will appear in the account. A second “no-show” will result in a flagged account, which requires a prepayment (non-refundable deposit) to schedule any further appointments*. The deposit will be applied toward services provided at the kept appointment. This appointment may be rescheduled once, preferably within 24 hours of the scheduled appointment. If the prepaid appointment results in a “no show”, the deposit is forfeited to mitigate lost
revenue for the hospital. Appointments that are rescheduled within 2 hours of the appointment will also forfeit the deposit. Consequently, a new prepayment (non-refundable deposit) must be collected to schedule another appointment.

We reserve the right to end the client-practice relationship with any client at any time. In this event, we will send a digital medical record for all active patients on the client’s account.

By signing below, you acknowledge that you have read, understand, and agree to the policy terms of White Oaks Veterinary Hospital.
Signature*

First NameLast Name
Should be Empty: