New Client Sign Up

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

You may either fill out the form below and submit online, or download our form to bring with you, or fax to us at 301-846-9912.

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 pets being admitted to the Hospital.
  • 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 our 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.

Pet Information

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