New Client Info New Client Info Client Information First Name * Last Name * Address * City * State * Zip Code * Email * Phone * Pet Information Name * Dog/Cat * Dog Cat Exotic Breed * Color/Markings * Age or DOB * Male/Female * Male Female Unknown Spayed/Neutered? * Yes No Unknown plus1 Add another pet minus1 Remove I understand that payment is expected at the time services are rendered. I hereby authorize the staff of VO Vets to render any treatment which is deemed necessary to the health of my pet(s) while in custody of the hospital. I understand that in the event of any unusual or emergency circumstances, the staff will make every attempt to contact me or my designated representatives before, if time permits, proceeding with the treatment. I understand that I will be financially responsible for all emergency procedures including the Estimate of Charges provided to me in person or over the telephone. I understand that a deposit is required for all pets admitted to the hospital. I understand that if my account is not kept in good standing, a finance fee of $25 will be added to the account and it will be forwarded to a third-party collections agency, which may affect my credit rating. I hereby acknowledge by signing this form I have authorized VO Vet’s use of my or my pet’s image/photo for training or marketing purposes (If you wish to opt out, please notify a staff member). * I have read and agree to the statement above. Signature of Owner / Agent / Good Samaritan * signature keyboard Clear Date * Captcha If you are human, leave this field blank. Submit