New Client Information Form

Onion River Animal Hospital provides our forms online so that you can fill them out in the comfort of your own home and at your convenience. You can find copies of our forms below. Please click on the gray button to bring up the form that you wish to fill out. Once you have filled out the form completely, press submit and your form will be sent directly to our office!

Note: Fields marked with a * are required fields. If you do not fill out a required field, you will not be able to submit your form. Please confirm that you receive confirmation of your form being received before navigating away from this page. Your results will not be saved and you will need to fill the form out again.

Primary Owner Name*
First Last
Preferred Pronouns
Primary Owner Drivers License #*
Primary Owner Email*
Address*
Street Address Address Line 2 City State ZIP Code
Home Phone #*
Cell Phone #
Work Phone #
Joint Owner
First Last
Joint Owner Phone
Do you have pet health insurance?
- Yes
- No
If so, what company?
How did you hear of our hospital? Name (we'd like to thank them!)
Please list all of the pets in the household (name, species, breed, sex, spay/neutered? date of birth)*
Consent*
I agree to pay fees for services rendered at the time the pet is discharged or the service is otherwise ended. In the event my account is unpaid for more than 30 days, I also agree to pay a billing fee per month on any balance due, as well as all reasonable collection costs (not to exceed 50% of the balance due), court costs, attorney fees and interest feeds accrued with the collection of this account. I understand that a service fee will be assessed for each non-sufficient funds check and/or certified letter that must be sent.*
Consent*
I understand that every effort will be made to achieve a successful outcome and to provide for all possible safety in patient care and handling. I authorize this hospital to receive, prescribe for, treat or perform surgery upon the pet(s) that I present for those services. I understand that requests for after-hours veterinary care may be referred to a veterinary emergency service.*
Pet's Instagram Handle (if applicable)
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New Client Information Form

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