2026 Small Ruminant Wellness Program

2026 Wellness Program Enrollment

For Small Ruminants & Camelids
Thank you for enrolling your pet(s) in the Elkhorn Veterinary Clinic Wellness Program. You are taking an important step in providing excellent preventive care to your pet at an affordable price. We look forward to being your partner in your animal's health.

If you need assistance enrolling your pet(s) or would like more information, please contact our office at 262-723-2644 or email us at largeanimals@elkhornvet.com.
Client Name:*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Please make sure you have clicked "save" after your last entry and the number of animals listed is the same number as the number of animals your are enrolling.
I am enrolling*

1 or 2 animals3 or more animals
Total number of animals I am enrolling today*
Total Due Today
$
Please charge my credit card on file.
Last 4 digits of credit card placed on file after 10/1/2022
I am choosing another form of payment:

Text me a link to pay in full.Call me for a current credit card to put on file.Check or cash.
In addition, I authorize the use of this credit card for the following:*

I authorize the use of this credit card to take advantage of the additional 10% discounts associated with the wellness program and recognize I will be billed at the time of service.I authorize the use of this credit card for all additional work done at the wellness program visit and recognize I will be billed at the time of service.I do not authorize the use of this credit card for any further purchases other than the purchase of the above wellness program(s). I realize that I may be foregoing any additional discounts offered by the wellness program.
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

2026 Wellness Program Enrollment