Name *

First

Last

Email *

Primary Phone *

Secondary Phone

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Who else is authorized to make decisions about your cat's healthcare?

First

Last

Phone

How did you find out about our hospital? If you were referred by someone, who should we thank? *

Cat's Name *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your cat have a microchip identification? *

Yes
No

What is the microchip number?

Do you have a second cat? *

Yes
No

Cat's Name *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your cat have a microchip identification? *

Yes
No

What is the microchip number?

Do you have a third cat? *

Yes
No

Cat's Name *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your cat have a microchip identification? *

Yes
No

What is the microchip number?

Do you have a fourth cat? *

Yes
No

Cat's Name *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your cat have a microchip identification? *

Yes
No

What is the microchip number?

Do you have a fifth cat? *

Yes
No

Cat's Name *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your cat have a microchip identification? *

Yes
No

What is the microchip number?

Payment is due in full at the time that services are performed. If being admitted into the hospital, we cannot begin the care of your cat until you have confirmed your desire to do so by 1) signing the client consent & estimate form, and 2) leaving an initial deposit of 50% of the upper end of the estimate. This is the only way that we have of knowing for certain that you want us to proceed with the care of your cat. We accept Cash, Visa, MasterCard, Discover, and CareCredit payments. We neither extend credit, nor bill for services. All open invoices are sent to collections after 45 days unless prior arrangements are made. *

I have read and accept the financial policy.

New Client Form for Cats in Hamilton

New Client Form

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