New Client Form

Sudbury Animal Hospital New Client Form - please allow 3 business days for processing and staff to contact you

* Indicates required field

Name *

First

Last

Phone Number *

Name - secondary owner *

First

Last

Phone Number -secondary owner *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Pet name #1, birth date, species, breed, color, sex, spayed/neutered *

Pet name #2, birth date, species, breed, color, sex, spayed/neutered, *

Pet name #3, birth date, species, breed, color, sex, spayed/neutered *

Previous Medical History - Please upload your pet's information here. We cannot create a new client profile without the previous medical history *

Max file size: 20MB

Reason for visit and other pertinent information: *

Preferred visit days and times: *

Sudbury Animal Hospital Policies: Please read before submitting form

DEPOSIT:
A non-refundable deposit of $100.00 is required for all new clients and is due when the initial appointment is scheduled, it will be applied towards your pet’s first appointment. Appointments cannot be reserved without a deposit via credit card or care credit. Please note that if you no-show for your first appointment, future appointments may or may not be made at the sole discretion of the practice manager.

PAYMENT: Payment for services rendered is due at the time of the visit. We DO NOT bill.
We accept cash, Mastercard, Visa, American Express and Discover credit cards
If you need a payment plan, you can apply for CARE CREDIT at www.carecredit.com

Cancellation and NO SHOW for appointments:
Need to cancel or reschedule? We request that appointments be cancelled with 24 hrs prior notice so that that time slot may be offered to another patient in need.
No show policy: We understand that life gets busy and things happen that can make you forget you had an appointment...but here is our NO SHOW POLICY if it happens more than once...
*1st time NO SHOW: Courtesy call, no fee assessed, and offer to reschedule the appointment
*2nd time NO SHOW fee: Client is asked to cover 1/2 office visit fee per patient scheduled
*3rd time NO SHOW fee: Client is asked to cover full office visit fee per patient scheduled
*After 3rd time, future appointments will change to drop off only appointments that will be scheduled at our convenience and assessed an in-patient care fee per patient in addition to services your pet receives.

REMINDERS: Text and email reminders are in effect for all clients with emails and mobile phone numbers on file, so make sure we have that information to enable the reminders for you. **We do not send out paper reminder cards, so if you need a copy of your pets vaccine and visit schedule to put on your calendar, please email us: [email protected] to request a copy. Also, you can sign up for a petly portal to get online access to your pet's information. Simply fill out the form on the petly portal page on our website or email us to request an invitation.

SCHEDULING APPOINTMENTS: We want to make sure that your pet gets all of their medical concerns addressed when they are in for a visit. Please make sure that you tell our reception staff everything that is going on with your pet when you are scheduling your visit. We have different time slots allotted for different types of visits, and we want to give you the time needed to cover all that is needed. Last minute add-ons may not be possible to accommodate due to the appointments that are on our schedule after yours.
Plan to arrive 10 minutes prior to your appointment time to check in.

ZERO TOLERANCE POLICY: Verbal abuse of staff
I acknowledge that anyone giving verbal abuse in any form to members of our staff, either in person, over the phone or online will be immediately dismissed as a client of Sudbury Animal Hospital. This behavior will not be tolerated in any form, for any reason. If you have an issue that needs to be addressed/resolved, please ask to be put in contact with the practice manager.

I have read and agree to all of the above terms, conditions and policies *

check here

Submit