New Client Sign Up Form

Important – Please Read

Please call our office at (301) 846-9988 to schedule an appointment. We require a deposit of $35.00 at the time of scheduling for all new client appointments. This deposit will be applied to your first visit. If you need to reschedule or cancel your appointment it must be done at minimum of 48 hours prior to the scheduled appointment, or your deposit will be forfeited.

Please submit the following information before your appointment. Having you in our system prior to your arrival will make the check-in process much faster.

Please fill out the form below and submit online:

Patient / Client Information
Address
City
State/Province
Zip/Postal
We would like to thank any individual who referred you.
At your request we will gladly discuss cost of services and/or prepare an estimate for recommended procedures.

24 hour supervision is not available for any animals in our care.

To assure consistent quality of products we cannot accept returns on any items not sealed in the original manufacture packaging. We will accept open food products in accordance with manufacture return guidelines.

Fees are DUE at the time services are rendered.

  • A deposit may be required for services at the time of drop off.
  • A deposit of $35.00 will be collected at the time of scheduling surgeries, grooming and boarding services.
  • We accept Cash, Checks, Debit, Visa, MasterCard, Discover and Care Credit.
  • We charge a $35.00 fee for returned checks.

State law requires rabies vaccination for everyone’s safety. To prevent the spread of infectious disease, all pets admitted for boarding, grooming and hospitalization are required to be current on vaccinations for transmissible diseases. We assume no liability for pets or humans contracting infectious diseases or parasites. Pets with fleas will be treated upon admission; the cost will be included on the invoice.

We require that all pets remain either on a leash or in a carrier until instructed otherwise by a staff member. If you do not have a leash or a carrier, we will provide one for you at a fee.

Cancelation/No-Show/Late-Arrival Policy

To promote efficient use of hospital staff and scheduling, Old Farm Veterinary Hospital has implemented a ‘Cancelation Policy’ to encourage clients to keep their doctor appointments, arrive on time, and give timely notice if they wish to change an appointment.
Due to an increased demand for appointments, we require prior day notice to cancel or reschedule appointments. If you do not cancel or reschedule the prior day, the appointment will be a “no-show”.
After the first no show, we will contact you at the phone number and/or e-mail you provided to reschedule at no extra charge and review our no-show policy.
After the second no show, you will be required to pay a deposit of $75 to reschedule and for any subsequent appointments. This fee will be assessed for each pet scheduled for multiple pet appointments. The deposit will be applied to the invoice for that appointment. The deposit will be forfeited in the event of another no-show or late cancelation.
If you are more than 10 minutes late for your scheduled appointment, it will be at our discretion to see your pet or to require rescheduling. If we are unable to see your pet due to excessive case-load, the late arrival will be considered a no-show.
We appreciate your understanding of our cancelation and no-show policy.

I Authorize Administration of Required Vaccines and Parasite Control as Needed for my Pets.
I understand that I am responsible for cost of all services performed at Old Farm Veterinary Hospital.I agree that I have been given the opportunity to discuss fees and recommended procedures with the Doctors or Staff of OFVH. Unless otherwise specified, I authorize release of medical records for the following services on request such as boarding, grooming, referrals to other veterinarians, or for other purposes.
 
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Pet Information

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