New Client Form

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New Client Form

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

Owner Information

Pet Information

Pet No. 1

Pet No. 2

I understand by my signature that I am responsible for any charges incurred by my pet while in the care of the doctors at the Hollin Hall Animal Hospital and that charges are due and payable at the time of service, unless other arrangements are made in advance. Any balance that is carried over for a period of 30 days will accrue a monthly finance charge of 1.75% or 21% per. Annum. Any balance that I leave unpaid will be forwarded to Hollin Hall Animal Hospital's collection agency, and will incur 35% collection fee for which I am liable, in addition to monthly finance charges.