New Client Form

Welcome

Thank you for giving us the opportunity to care for your pet. To ensure the best care possible, please take the time to fill in this form completely.

  • Needed for Controlled Substances
  • Needed for Controlled Substances
  • Village Veterinary Hospital and Companion Animal Eye Care requires payment in full at the end of your pet’s examination and/or at the time of discharge. For some treatment or hospitalized care, a deposit is required. Healthcare plans requiring comprehensive care of more than $500, will require a 50% deposit to begin your pet’s treatment.

    Payment forms accepted: Cash, Visa, Mastercard, American Express, Discover, and Care Credit.

    WE DO NOT ACCEPT CHECKS.

  • (Companion Animal Eye Care patients only)
  • Pet #1

  • Pet #2

  • Pet #3