New Client Form

Welcome to Westwood Veterinary Clinic! Please complete your new client form online before your first visit.

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Westwood Veterinary Clinic New Client Form

We look forward to meeting you soon! Complete the form below prior to your first appointment with us.

Name *

First

Last

Email *

Primary Phone *

Secondary Phone

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Who else is authorized to make decisions about your pet's healthcare? *

First

Last

Phone

How did you find out about our clinic? If you were referred by someone, who should we thank? *

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Yes
No

Payment is due in full at the time that services are performed. If being admitted into the clinic, we cannot begin the care of your Pet until you have confirmed your desire to do so by 1) signing the client consent & estimate form, and 2) leaving an initial deposit of 50% of the upper end of the estimate. This is the only way that we have of knowing for certain that you want us to proceed with the care of your Pet. We accept Cash, Visa, MasterCard, Discover, and CareCredit payments. We neither extend credit, nor bill for services. All open invoices are sent to collections after 45 days unless prior arrangements are made. *

I have read and accept the financial policy.

Name

New Client Form

Westwood Veterinary Clinic New Client Form

MAKE A VETERINARY APPOINTMENT
GREENFIELD, INDIANA.

OUR ADDRESS

Contact

HOURS

AFTER HOURS

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