New Client Form

New Client Form

Please use this form to request an appointment.

You may also contact our office at (602) 840-3446 or email us at ingleside@ingleside.com .

Your Information
Pet Information
Cat / Dog / Other
Vaccinations
Agreement
TO PREVENT THE SPREAD OF INFECTIOUS DISEASES AND PARASITES, HOSPITALIZED AND BOARDED ANIMALS MUST BE CURRENT ON ALL VACCINES AND FREE OF EXTERNAL PARASITES.

I authorize and direct the veterinarians at Ingleside Animal Hospital to diagnose, prescribe, perform therapeutic procedures, and/or surgery that their judgment may dictate to be advisable for the patient’s well being. No warranty or guarantee has been made as to the result or cure.

Accounts that are not paid in full may be placed with a collection agency. I further agree to pay all collection costs, responsible attorney fees, and other costs that may be incurred to enforce collection of any outstanding amounts.

 

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