Registration

 

Welcome to Family Pet Health Care! Registration Forms are now available online for your convenience. Please fill out this form completely if you are new to our clinic. When finished be sure to click submit at which time you will receive a confirmation message. Please read all of the form before signing. You will only need to do this one time. Or if you prefer we also have the following forms available for download so you can print a copy, fill out completely and bring with you the day of your appointment.

 

DogCatOther
MaleFemale

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Permission to Use Photograph
I grant to Family Pet Health Care, its representatives and employees the right to take photographs of me, my pet(s) and my property in connection with the above identified subject. I authorize Family Pet Health Care, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Family Pet Health Care may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.

Yes, I agree.No, I decline.

I assume the responsibility for all charges incurred in the care and treatment of my animal(s). I also understand that these charges will be paid at the time of release and a deposit may be required for treatment. In the event any account is not paid when due, the prevailing party shall be entitled to recover its reasonable attorney fees and any court costs, including costs of appeal or other review. In the event that your account is placed for collection with a collection agency, you agree to pay any collection fees that may be assessed in addition to the amounts owing.

by checking this box I agree to the aforementioned paragraph.