New Client Form

We are happy to welcome you to O’Neal Lane Pet Hospital. Please take a few minutes to fill out this form as completely as possible. If you have any questions, please ask one of our staff for assistance. We look forward to working with you in maintainingyour pet’s health.

Payment

All professional fees are due at the time services are rendered. In cases of extensive medical or surgical procedures where full payment may be difficult at discharge, we accept major credit cards or CareCredit. There will be a service charge for any check returned unpaid.To preventthe spread of infectious diseases, all hospitalized patients mustbe current on all vaccinesand free from internal and external parasites. The signature below authorizes this level of preventative care and the appropriate charges will be assessed in the discharge invoice.Subscriber uses PetDesk® to manage client communications, send you reminders about upcoming appointments, and send you offersabout our products and services. You agree that we may share your name, pet’s name, email address, address, and phone number with PetDesk to facilitate this process. To learn more about PetDesk or their privacy policies, please visit www.PetDesk.comor download their iOS or Android mobile applications.I grant permission to O’Neal Lane Pet Hospital to use my/my pets’ image(s) (photographs and/or video) for use in Media publications. I hereby waive any right to inspect or approve the finished photographs or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of the image.