NEW PATIENT REGISTRATION
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Please visit our web site at altitudevet.com to sign up for our
FREE Pet Living & Wellness E-Newsletter
· How did you learn about our clinic? (Please circle one)
FRIEND CLIENT* WEB SITE LOCATION NEWSPAPER YELLOW PAGES
OTHER SERVICES: GROOMING BOARDING TRAINING
*If referred by one of our clients, please provide their name so we may thank them
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· Please provide information on your previous vet if you would like us to obtain your pet(s) records
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PATIENT INFORMATION
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All payments are due at the time of services rendered.
We accept cash, checks, all major credit cards, & Care Credit which can be approved in as little as 10 minutes.
I have read and understand the above statements and agree to all terms therein.
Signature:_________________________________ Date: __________________
Please note: Your privacy is important to us. All information received in all forms and through other communication is subject to our Patient Privacy Policy.
