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Hours 4039 Carpenter Rd Suite B
Ypsilanti, MI 48197

New Client Form

Welcome! Thank you for giving us the opportunity to care for your pet(s). So that we may become better acquainted, please complete the following:

Date of Scheduled Appointment:*

Time of Scheduled Appointment:*

How did you become aware of our clinic?

Personal Recommendation (whom may we thank?)

Please list any previous clinics/hospitals your pet has visited so we may try and retrieve records prior to your visit.

If your pet was seen at a previous veterinary clinic under a different client name than yours, please enter that name below.

South Arbor Animal Hospital has my permission to post my pet's picture on our social media.

Yes

No

For the safety of all of our staff, we expect all of our patients to be up to date on their Rabies vaccine. I understand that in order to get complete care of my pet or pets, I may be required to get them vaccinated for Rabies if they are not already.*

Agree

Disagree

All fees are due at the time services are rendered.
We accept Visa, Mastercard, Discover, and American Express credit cards as well as cash and personal checks. Any balances carried at South Arbor Animal Hospital will be charged a monthly service charge on all accounts over 30 days equal to the greater of a minimum charge of $5.00 or 1.50% per month which is an annual percentage rate of 18.0%.*

Agree

Disagree

Pet Information

Pet Information #1:
Please provide your pet's Name, Species, Breed, Color, Birth Date, Sex, and if he/she is spayed or neutered.*

Pet Information #2:
Please provide your pet's Name, Species, Breed, Color, Birth Date, Sex, and if he/she is spayed or neutered.

Pet Information #3:
Please provide your pet's Name, Species, Breed, Color, Birth Date, Sex, and if he/she is spayed or neutered.

South Arbor Animal Hospital