Thank you for giving our hospital the opportunity to care for your pet. So that we may create an account for you and a chart for your animal, please take a moment to complete the following.
Contact Email Address (required):
(In an effort to keep you informed of your pet’s status we must have at least two phone
numbers where we can reach you or an emergency contact person. Thank you for your
If necessary, may we call you at work? YesNo
Employers name: Work Number:
How did you first hear of us? Yellow PagesSignInternetOther
Pets Name: Sex: MaleFemale
Spayed / Neutered?: YesNo
Approximate date of birth or age of pet now: Todays date:
Any previous serious illness or surgeries?
Any allergies to vaccinations or medications?
Is your pet on any special diet or medications?
Do you feed your pet table scraps or bones? How Often?
Do you have pet insurance today? YesNo
How will you be paying for today's services? CashCheckCredit CardCare Credit
CA driver's license or CA I.D. number:
The staff at Abby Pet Hospital is devoted to providing you and your pet with the best
veterinary care possible. To allow us to focus on this important job and remain effective
and efficient, we have adopted the following policy concerning payment for our services.
1. Payment is expected when services are rendered.
2. We accept cash, checks (with proper I.D.), Visa, MasterCard, Discover, American
Express, and Care Credit. In an effort to protect you, we will not accept credit card
payment over the phone. You must be present at our office and have a valid I.D.
3. We offer billing for unexpected costs through Care Credit only. Care Credit is a
separate lending company and clients must qualify and be approved for this credit
plan. Our clients must apply for this credit plan prior to payment and will find out if
their credit is approved within 15 minutes in most cases. All billing requests through
Care Credit should be addressed to them to allow our staff to focus on treating your
pets. If interested, ask a receptionist how to apply for Care Credit.
4. Pet insurance is accepted for approved procedures.
Please do not discuss fees and billing with your veterinarian. Your veterinarian is there to service the needs of your pet and others; our veterinarians are not authorized to make billing or credit arrangements. Fees and billing are handled by our credit managers, not by the veterinarians. We do not offer independent payment plans through our hospital.