Online Client Forms

Before bringing a new pet to our clinic or bringing them in for a surgical appointment, please take a moment to complete the necessary form provided below! You can fill out the form from your desktop or mobile device. Let us know if you have any questions by calling (334) 598-1117.

New Client Registration Form

New Client Registration Form

Thank you for trusting us to take care of pets in your household. To help us provide the best care possible, please take a few moments to fill out this form completely. Thank you!
Owner's Name
Owner's Name
First
Last
Spouse's Name
Spouse's Name
First
Last
Address
Address
City
State/Province
Zip/Postal

Pet Information

Is your pet current on its vaccinations?
plus1 Add minus1 Remove
Species
Sex

Maximum file size: 52.43MB

Authorization

I hereby authorize the veterinarian to examine, prescribe for, and/or treat the above-described animal(s). I assume full responsibility for all charges incurred for the care of this animal. I also understand that these charges will be paid at the time of service and/or release and that a deposit may be required for surgical treatment. I understand that any animal not picked-up within 3 days of the date that the hospital designated for its release, shall be considered abandoned by me and shall be disposed of at the discretion of the hospital. My financial responsibility shall not in any way be decreased by such disposal and my indebtedness includes all charges including cost of having held animal up and to including the date of disposal as well as the cost thereof.