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New Client Information Form

The form below, helps us serve you better. Please fill out the information below as best as you can, some fields are required. We will have you sign this form in person when you arrive at the hospital check-in desk. We look forward to meeting you and your pet!

    Your email information will only be used to send you valuable pet health information from Adamstown Veterinary Hospital . We will also use the contact information to send you reminders through our reminder system AllyDVM. You may opt out of the reminder system at anytime.
    Adamstown Veterinary Hospital’s policy is to prevent the spread of infectious disease and parasites. Hospitalized animals must be current on all vaccines and free of internal and external parasites.
  • I understand that by initialing above (we will have you sign at the hospital), I certify that I am the owner/authorized agent for the pet presented, and am responsible for any decisions regarding said pet. I agree to be responsible for all charges incurred in the treatment of my pet while in the care of the doctors and staff of Adamstown Veterinary Hospital (AVH) and that payment in full is due at the time of services rendered. I understand that I can request a written estimate prior to treatment if I desire. Adamstown Veterinary Hospital accepts all major credit cards, Care Credit, and cash. We do not accept personal or business checks.
  • This field is for validation purposes and should be left unchanged.
/* Updated March 1, 2018 */