Name *

First

Last

Owner's Date of Birth *

Email *

Primary Phone *

Secondary Phone

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Yes
No
Unknown

Do we have permissions to post a picture of your pet on our social media page? *

Yes
No

How did you hear about us? *

Payment is due in full at the time that services are performed. If your pet is being admitted into the hospital, we cannot begin diagnostics and treatment until you have confirmed your desire for services by 1) signing the Client Consent & Treatment Plan forms and 2) fulfilling your payment obligations specified by PGAH. This is the only way we know for certain that you want us to proceed with your pet's care. We appreciate you entrusting us with the care of your pet. We want what is best for your pet! We understand that having a sick pet is often an emotional time. The best veterinary-client relationships are based on trust, communication, and mutual respect. We will treat you and your pet with kindness and ask that you do the same for our team. Abusive, disrespectful language, yelling, threats, as well as racist, sexist, homophobic or transphobic language will not be tolerated and are grounds for immediate termination of our relationship. Please let us know if you have any concerns or questions. All items or services purchased from Pacific Grove Animal Hospital are non-refundable. *

I have read and accept the financial policy.

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