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New Client Information Form

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New Client Info

Client Information

How did you hear about us?

Pet Information

Number of Pets *

Pet 1

Dog/Cat *
Male/Female *
Spayed/Neutered? *

Pet 2

Dog/Cat *
Male/Female *
Spayed/Neutered? *

Pet 3

Dog/Cat *
Male/Female *
Spayed/Neutered? *

Pet 4

Dog/Cat *
Male/Female *
Spayed/Neutered? *

Current Veterinarian

Do you currently have a family veterinarian? *
Would you like us to contact a previous vet for records for your pet?

Acknowledgment and Signature

I understand that payment is expected at the time services are rendered. I hereby authorize the staff of Sunset Animal Hospital to render any treatment which is deemed necessary to the health of my pet(s) while in custody of the hospital. I understand that in the event of any unusual or emergency circumstances, the staff will make every attempt to contact me or my designated representatives before, if time permits, proceeding with the treatment. I understand that I will be financially responsible for all emergency procedures including the Estimate of Charges provided to me in person or over the telephone. I understand that a deposit is required for all pets admitted to the hospital. I understand that if my account is not kept in good standing, a fi nance fee of $25 will be added to the account and it will be forwarded to a third-party collections agency, which may affect my credit rating. *