• New Client Form

  • Docton Animal Clinic

    Welcome to our Practice!
  • Our Mission Statement: The compassionate and devoted healthcare team of Docton Animal Clinic strives to encourage client education, provide preventative care, deliver leading diagnostics and treatments, and support healthy pet ownership.

  • Format: (000) 000-0000.
  • Phone number type
  • Primary Owner Date of Birth
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Phone number type
  • How did you find us?
  • What time frame are you hoping to schedule an appointment?
  • Pet Information

  • Pet Type
  • Pet Sex
  • Pet Type
  • Pet Sex
  • Pet Type
  • Pet Sex
  • If you have additional pets, we will collect their information when we speak with you.

  • Format: (000) 000-0000.
  • Financial Policy & Payment Options

    Docton Animal Clinic requires payment in full at the end of your pet's examination or at the time of discharge. We do not offer billing. All fees are due at the time of service and must be paid upon your pet’s discharge from the clinic. In cases where your pet requires treatment or hospitalized care, we require a 50% deposit of the high end of the estimate before starting treatment.

    We accept cash, check (with a valid ID), Visa, Master Card, Discover, and American Express. We also accept Care Credit (card holder must be present at time of visit with a valid photo ID. This is required every time the card is used). Care Credit is a healthcare credit card designed exclusively for healthcare services with special financing options. Learn more by visiting www.carecredit.com; subject to credit approval. 

    In the event of an open balance, the outstanding balance will incur a monthly interest fee of 1.5% until the total balance due is paid. For accounts that have an outstanding balance, you will be required to pay the outstanding balance in full prior to scheduling future appointments.

    We use Bounce Back Check Recovery Services for all returned checks. There is a returned check fee of $35.00 or state allowed maximum for any checks that are returned to our clinic.              

  • New Client Deposit Policy

    Docton Animal Clinic requires a $30 deposit per pet when making your pet’s initial appointment(s). The deposited amount will be applied toward your invoice on the day of service. If you are unable to keep your appointment and cancel within 24 hours, this deposit will be refunded. If the appointment is missed, cancelled with less than 24 hours’ notice or you arrive 10 minutes past your appointment time, this deposit is forfeited.

  • Appointment Cancellation, No Show and Late Arrival Policies

    We strive to provide excellent medical care for all our patients. When an appointment is scheduled, that time has been specifically reserved for you and your pet and when it is missed, that time cannot be used to treat another patient in need of care. Therefore, we request that you:

    ·         Confirm your appointment when appointment reminders are sent and/or return our phone call when we call to remind of the upcoming appointment.

    ·         Give our office at least 24 hours’ notice in the event that you need to cancel or reschedule your appointment.

    No Show: If you do not provide us with a 24 hour notice, or if you do not arrive for a schedule appointment, you will be charged a missed appointment fee.

    • If you miss a surgery appointment, you will incur a $75.00 fee.
    • If you miss an exam appointment, you will incur a $30.00 fee.
    • If you miss a RVT or Assistant appointment, you will incur a $15.00 fee.

    Arriving Late: If you are 10 minutes or more late, your appointment will be considered a missed appointment, and a missed appointment fee will apply. Your appointment will need to be rescheduled, and we will no longer be able to work your pet into our schedule that day. Rescheduling is dependent on our availability and the next available appointment may be several weeks out.

    We understand that unexpected circumstances can happen.  If you know you are going to be late, please call our office 937-372-6391 as soon as possible so that we can discuss the best option for your pet’s care.  

    Thank you for your understanding and for helping us keep our appointments running smoothly.

  • Medications and Refills

    The State of Ohio requires a valid veterinarian-client-patient relationship for a veterinarian to prescribe and/or dispense prescription medication. All medications require a yearly exam to be performed by the prescribing veterinarian. Controlled substance medications require an exam by a veterinarian every 6 months. Please keep in mind some medications require blood work to be performed every 6-12 months. We ask for 24 hour advanced notice for refill requests or 48 hours for controlled substances. This will allow us the time to review your pet’s medical chart to ensure the correct dosage is given, as well as to acquire doctor authorization to refill the medication.

  • I have read and understand the Docton Animal Clinic Policies. I understand that Docton Animal Clinic is not a financial institution and does not extend credit of any nature. I understand that all services are to be paid at the time they are rendered. I further understand an estimate can be provided to me at any time that I request one. I hereby authorize the veterinarians at Docton Animal Clinic to examine, prescribe for, and treat the pet(s) on my account.  Any animal admitted/hospitalized shall receive the necessary diagnostic tests and treatments to ensure proper medical care. I understand that a deposit may be required for surgical or medical treatment. By my signature below, I hereby agree that all information provided above is current and correct and I agree to all of the above policies and agree to pay for all services and medications rendered, supplies and goods purchased today and in the future. 

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