479-273-0622
contactus@roseanimalclinic.com
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Rose Animal Clinic
New Client Form
Thank you for considering our hospital as your pet’s provider of
veterinary services
. We are dedicated to maintaining the health of your pet and look forward to many future years together.
Get Started
New Client Form
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Email
*
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Secondary Phone
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Who else is authorized to make decisions about your pet's healthcare?
*
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How did you find out about our hospital? If you were referred by someone, who should we thank?
*
Pet's Name
*
Species (dog, cat, etc.)
*
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*
Sex
*
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Does your pet have a microchip identification?
*
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What is the microchip number?
Payment is due in full at the time that services are performed. If being admitted into the hospital, 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.
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