New Client Info

Minnieville Animal Hospital offers our new patient form online so you can complete them in the convenience of your own home or office. Simply fill out the form below, and we will receive your submission electronically.

New Client Info

Client Information

How did you hear about our animal hospital?

Pet Information

Number of Pets *

Pet 1

Dog/Cat *
Male/Female *
Spayed/Neutered? *

Pet 2

Dog/Cat *
Male/Female *
Spayed/Neutered? *

Pet 3

Dog/Cat *
Male/Female *
Spayed/Neutered? *

Pet 4

Dog/Cat *
Male/Female *
Spayed/Neutered? *

Current Veterinarian

Would you like us to contact a previous vet for records for your pet?
I understand that payment is expected at the time services are rendered. I hereby authorize the staff of Minnieville Animal Hospital 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 understand that photos/videos may be taken of my pet for training or marketing purposes.

Late cancellations: A cancellation will be considered late when the appointment is canceled without 24-hour advance notice.

Appointment late cancellation/no-show policy: A no-show is a client who misses an appointment without canceling it. Failure to be present at the time of a scheduled appointment will be recorded in the patient’s chart as a no-show; this includes arriving 15 minutes after your scheduled appointment. The first time there is a no-show or late cancellation there will be no charge to the client. A 2nd occurrence will result in you being charged a cancellation/no-show fee of $30.00. The 3rd occurrence will result in you being charged the cost of the type of exam and time allotted for your pet’s appointment; Annual/Sick Exam – $60.00, Booster/Follow up Exam – $30.00.

Get the best care for your best friend.