New Patient Form

New Patient

Please provide the information below as completely as possible. All information is strictly confidential.

Pet Information

Statement Of Ownership and Responsibility

By checking below I certify that I am responsible for any charges incurred by my pet(s) while in the care of the doctors at Airport Animal Hospital and that charges are due and payable at the time of services. I authorize and direct the veterinarians at Airport Animal Hospital (and their designated assistants) to administer authorized treatment as needed on the basis of findings during the course of evaluation: to diagnose, prescribe, sedate, anesthetize, perform therapeutic procedures and/or surgery as their judgment may dictate to be advisable for the patient's well being. I understand that I will be advised as to the nature of the procedures and the risks involved. I understand that no warranty or guarantee will be made as to the results or cure.

Enter the verification code in the box below.