New Patient Form

Save time before your mobile veterinary appointment! Complete your new patient form online from any device at any time before we visit.

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New Patient Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s).

Name *

First

Last

Email *

Primary Phone *

Pet Information

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Gender *

Male
Neutered Male
Female
Spayed Female

Pet Age/D.O.B. *

What clinic was your pet previously seen at? *

Reason for visit? *

Preferred appointment time and day? *

Do you give Hall Veterinary Services permission to use photos of your pet for social media? *

Yes
No

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.

*

By checking this box, I agree to be contacted by Hall Veterinary Services via call, email, and text. To opt out, you can reply 'stop’ at any time. For more information, see our privacy policy. Message and data rates may apply.

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New Patient Form

New Patient Form

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