Blank Form (#4)

New Client Check-In

If you would like to make an appointment, you can assist us to expedite your check in by submitting this form. If it is easier you can instead feel free to print our New Client Form to fill out and bring with you. Thank you for your cooperation in letting us assist you.

Spouse, Partner, or Significant Other

Please read

I understand, by indicating I agree and submitting this registration, that I am responsible for any charges incurred by my pet while in the care of the doctors at Alpine Hospital for Animals and that charges are due and payable at the time of service. Any balance that is carried over a period of 30 days will accrue a monthly finance charge of 1.5% or 18% per annum. Any balance that I leave unpaid will be forwarded to Alpine Hospital for Animals's collection agency, and will incur a collection fee for which I am liable, in addition to monthly finance charges.