Name *

First

Last

Email *

Primary Phone *

Secondary Phone

Which number is best to reach you? *

Primary Phone
Secondary Phone

Would you like to opt in to receive text messages from Case Veterinary Hospital? *

Yes
No

Are you in the Military? *

Yes
No

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Who else is authorized to make decisions about your pet's healthcare? *

First

Last

Phone

How did you find out about our hospital? If you were referred by someone, who should we thank? *

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Color *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Yes
No

Microchip #: *

Please upload any copies of your pet's records here, if possible.

Click or drag a file to this area to upload.

If you don't have e-records, you can provide them in person.

Payment is due in full at the time that services are performed. If being admitted into the hospital, we cannot begin the care of your pet until you have confirmed your desire to do so by 1) signing the client consent & estimate form and 2) leaving an initial deposit of 50% of the upper end of the estimate. This is the only way that we have of knowing for certain that you want us to proceed with the care of your Pet. We accept Cash, Visa, MasterCard, Discover, CareCredit, and Scratchpay payments. We neither extend credit nor bill for services. Any balance brought forward is subject to a 1.5% finance charge. All open invoices are sent to collections after 45 days unless prior arrangements are made. *

I have read and accept the financial policy.

I give you permission to medically treat my pet.

New Clients

Client / Pet Information Form

Your preferred Savannah veterinary hospital.

Contact

Hours

Location

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