New Client Form

  • Date Format: MM slash DD slash YYYY

  • Emergency Contact Info

  • (Refer a friend and receive a credit on your account!)

  • Pet Information

  • Pet Name

  • Cat / Dog

  • Breed

  • Colour / Markings

  • Date of Birth / Approximate Age

  • Sex

  • Heartworm Prevention

  • Microchip

  • Pet Insurance

  • Tell us which of your pets has this vaccination.
  • Tell us which of your pets has this vaccination.
  • Tell us which of your pets has this vaccination.
  • Tell us which of your pets has this vaccination.
  • Tell us which of your pets has this vaccination.
  • Tell us which of your pets has this vaccination.
  • Tell us which of your pets has this vaccination.
  • Tell us which of your pets has this vaccination.
  • Tell us which of your pets has this vaccination.
  • Tell us which of your pets has this vaccination.

  • Payment Policy

    Full payment is required upon the rendering of our services. Deposits are required on major medical and surgical cases and emergency cases where hospitalization is required.

    We happily accept cash, Mastercard, Visa, Discover, American Express and check. We do not carry open accounts and hope the above options are convenient for you.

  • Permissions

    To prevent the spread of infectious diseases and parasites, hospitalized or boarded animals must be current on all vaccines and be free of internal and external parasites. I authorize Hawthorne Animal Hospital to perform and I guarantee to pay for any such vaccinations and parasite tests and treatments.

    In the event of an emergency, I authorize Hawthorne Animal Hospital to perform life stabilizing treatments.

    Separately, we would also like permission to share your pets on social media sites for the purpose of education and promotions. No names of ownership will ever be shared.