New Patient Form - Otay Pet Vets printable pdf download

New Patient Form

Owners Name: __________________________________________ Home or Cell: _______________________

Co-Owner’s Name: _______________________________________ Home or Cell: _______________________

Best number to TEXT pictures or information concerning your pet: _________________________

Address: __________________________________________ City: ___________________________________

State: _________ Zip: ______________

E-Mail Address for your pet vaccination reminders and e-pet health on line portal:

_________________________________________________________________________________________

Can we post pictures of you/pet’s on Facebook, Instagram, and website? Yes or No

|Tuesday Market |Personal Recommendation (Whom may we thank?) ______________________________

First Pet

Second Pet

Third Pet

Your pets name

Breed/color

Age/Birthday

Sex/

Spay/Neut.

Nick Name

Our technicians and doctors will go over your pet’s history and vaccinations in the exam room.

To provide a relaxed and personalized atmosphere with caring doctors and staff who maintain the highest standards of medicine. If, at any time

during your relationship with our hospital you feel there is something that needs to be brought to our attention, in order for us to serve pets and

their people more efficiently, please let us know. OWNER RELEASE: I hereby authorize this hospital to receive, prescribe for, treat or perform surgery

upon the pet(s) listed this sheet I present. Furthermore, I agree to pay fees for services rendered at the time the pet is discharged from the hospital

or the service is otherwise terminated I understand that veterinary service is not provided during night time hours. Thank you for choosing Otay Pet

Vets! Large to Small, We Love them All!

All Medical services and fees are due at the time services are rendered, Thank you! Ask us about our Pet Care Rewards program

SIGNATURE______________________________________________DATE___________________

Let us know how we did by giving us a review on our website, thank you!