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.
  • Checks must be authorized by Telecheck. 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.

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.
 
Please type your signature below.

Pet Information

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