Welcome To Desert Veterinary Clinic, PLC

WE STRIVE TO MAKE EACH OF YOUR PET’S VISITS PLEASANT AND COMFORTABLE

Name *

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Last

Address *

Address Line 1

Address Line 2

City

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Zip Code

Email *

Primary Phone *

I consent to receive SMS text messages from Desert Veterinary Clinic. Msg & data rates may apply. Reply STOP to opt-out. *

Yes
No

Secondary Phone

Driver's License #

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

Is your pet a: *

Have your pet(s) travelled out of the area? *

Yes
No

Where and when?

Please note any behavioral problems needing assistance:

Pet's Name *

Species (dog, cat, etc.) *

Color *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Preferred method of payment:

I certify that I am 18 years of age or older and that I am legally and financially responsible for the treatment my pet(s) receives at Desert Veterinary Clinic. I herby authorize the veterinarian to examine, prescribe for, and treat my animal(s). I understand that FULL PAYMENT IS DUE AT THE TIME SERVICE IS RENDERED and that a DEPOSIT IS REQUIRED FOR ANY HOSPITALIZED PET. I have read and understood Desert Veterinary's Clinic billing policy and I accept responsibility for all fees. I understand if I fail to pay as agreed, legal action will be taken against me. I understand that there are no staff members on the premise after hours. Phone calls after hours will be forwarded to the answering service and the doctor on call will be called with any medical emergencies. *

I authorize the use of the name and/or picture of my pet(s) for media purposes such as Facebook etc at any time
I do NOT authorize the use of the name or picture of my pet(s) for media purposes

Signature *

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Date *

Online forms

New Client Form

Welcome To Desert Veterinary Clinic, PLC

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Where to Find Us

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Our Hours