New Client Form

NEW CLIENT / PATIENT INFORMATION

Name(Required)







Address












preferred#(Required)



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PET(s) INFORMATION


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Sex(Required)


Status(Required)




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Sex


Status




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Sex


Status



I hereby give permission to Hamilton Mill to take photos and videos of me and my pet(s) for the purpose of posting on social media sites and release and discharge Hamilton Mill from any and all claims arising out of use of the photos/videos. Hamilton Mill Animal Hospital has my permission to use the photos and videos.

PRACTICE PHILOSOPHY

Thank you for choosing Hamilton Mill Animal Hospital. We are a full service hospital. Our philosophy is to practice quality Veterinary medicine. Our fees are based on our cost to provide this type of service. We do not bill. We accept cash, checks, VISA, Mastercard, Discover, American Express and Care Credit. I accept responsibility for payment for each visit.


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