New Client Form

Thank you for choosing us!

Please complete the following form before your first visit, and a member of our team will be in touch shortly if we have any questions. Please Note: Any fields with * are required.

Name *

First

Last

Email *

Primary Phone *

Secondary Phone

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

May we communicate with you via text?

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 *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Photo release: I grant permission to Osceola Veterinary Clinic, its representatives, and employees the right to take pictures of my pet(s) to use for marketing and promotional purposes. I authorize Osceola Veterinary Clinic to copyright, use, and publish these photographs in both print and/or electronically. *

I grant permission.
I do not grant permission.

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 we have to know for certain that you want us to proceed with your pet's care. We accept Cash, Visa, MasterCard, Discover, and CareCredit payments. We neither extend credit nor bill for services. All open invoices are sent to collections after 45 days unless prior arrangements are made. *

I have read and accept the financial policy.

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New Client Form

Thank you for choosing us!

Your preferred Osceola veterinary hospital.

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