New Client and New Patient Form

AUTHORIZATIONS, HOSPITAL POLICIES, PREVIOUS RECORDS, AND PATIENT PHOTO

I hereby authorize the veterinarian to examine, prescribe for, or treat the above-described pet. I assume all responsibility for all charges incurred in the care of this animal.

Do we have your permission to share {patientName}'s image and story on our social media, website, and other forms of related media?

Hospital Policies

APPOINTMENTS: To allow for ample time for all patients and surgical procedures, Shady Brook Animal Hospital operates primarily by appointment. We request all our clients be on time for scheduled appointments and procedures. If you are 10 minutes late to your appointment, you may be asked to reschedule your appointment. We do take emergencies; however, these services may be subject to a higher fee schedule. For your convenience, we offer limited same-day appointments for urgent care sick patients; they fill up fast, so we recommend calling first thing in the morning.

ARRIVAL: For your protection and that of others, pets MUST be properly restrained by a leash or carrier upon arrival. If your pet requires special accommodations, please give us a call when you arrive so we can assist you and your pet.

RESCHEDULING/CANCELLING: We understand that unexpected situations arise and that appointments may occasionally need to be rescheduled or cancelled. As a courtesy, we do not charge cancellation or rescheduling fees. However, if appointments are frequently canceled or rescheduled, we may require a non-refundable deposit or ask that your pet be scheduled as a drop-off visit to help us best manage our schedule and accommodate all patients.

PAYMENT: Payment is due in full at the time of service. We accept cash, debit, all credit cards, and pet insurance. We also offer CareCredit or Scratch Pay financing to help make the highest quality care accessible to all our patients. We do not offer in-house payment plans.

PRESCRIPTION REFILLS: We would be more than happy to fill your prescriptions or have your food orders ready for pickup. Please call ahead or use our website to process refills. Please allow 24-48 hours for prescription refills; special orders, compounded medications, or controlled substances may require longer. We do not authorize or call in online pharmacy requests by phone or fax; if you need a written prescription to be processed at the pharmacy of your choice, you will need to pick it up in person at our hospital.

THIRD-PARTY PHARMACY PRESCRIPTIONS & MEDICATION REQUESTS POLICY

At Shady Brook Animal Hospital, we understand there are many reasons clients may choose to purchase medications or preventatives from online retailers or outside pharmacies. We fully support your ability to choose where you obtain your pet’s medications and are happy to accommodate those requests.

To help ensure the safety and quality of your pet’s medications, we strongly encourage purchasing products only from properly accredited and certified veterinary pharmacies. However, if you choose to use an outside pharmacy, we want to make the process as simple and transparent as possible.

Our Prescription Process
Clients who choose to fill prescriptions through an outside pharmacy may request a written prescription from Shady Brook Animal Hospital.

Please note:
- Written prescriptions can be picked up directly from our hospital.
- We do not call prescriptions into outside pharmacies.
- We cannot email a copy of the written prescription to you.
- We do not approve or process prescription requests submitted directly by online pharmacies via phone, fax, or electronic request.

This process allows us to better serve our patients while maintaining safe and accurate prescribing practices.

Why We Use This Process
We implemented this policy for several important reasons:

Patient Care Comes First
- Our priority is caring for our patients and providing support to our clients. Managing large volumes of faxed and electronic refill requests from outside pharmacies can be time-consuming and may reduce the time available for patient care. In many cases, refill requests are generated automatically by online pharmacies rather than initiated directly by pet owners, which can create confusion and delays.
Improved Prescription Accuracy
- Providing a written prescription creates clear documentation and reduces the risk of communication errors that can occur when information is relayed over the phone or through third-party systems.

Ordering Directly Through Shady Brook Animal Hospital
We encourage clients to consider purchasing medications directly from our hospital or through our online pharmacy. Our online store is regularly evaluated and compared with the most popular online pharmacies to offer our clients similar (or the same) pricing on most prescriptions.

When ordering through our clinic or online store:

No written prescription is required.
Orders are integrated directly with your pet’s medical record.
The medication supply chain is fully secure.
Products are stored, handled, and packaged according to manufacturer standards.
You are guaranteed authentic, name-brand products in the correct dosage and packaging.
Most importantly, medications purchased directly through Shady Brook Animal Hospital or our online store are backed not only by the manufacturer but also by us—your pet’s healthcare team.

We appreciate your understanding and thank you for allowing us to partner with you in your pet’s care.

THIRD-PARTY PHARMACIES: I understand that Shady Brook Animal Hospital will not approve prescription requests through third-party pharmacies such as Chewy, Costco, Amazon, etc. I understand that if I prefer to obtain my pet's medications via these platforms, I will need to pick up a written prescription from Shady Brook Animal Hospital and present it to the pharmacy of my choice.

Signature

Date

MonthDayYear

PREVIOUS MEDICAL RECORDS

Please upload any previous medical records and/or vaccine history. This helps us keep appointments on time and know exactly what your pet needs.

PET PHOTO:

Please feel free to upload your favorite picture of {patientName}, and we will update {patientName}'s hospital chart to include their photo.

*This photo will not be used for any other purpose than the patient's hospital chart. Uploading a photo does not give the hospital permission to use this photo on any social media accounts.

Please verify that you are human