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santa pet

Pet Pictures with Santa

Join us on Saturday, Dec. 1st from 1-3 pm for beverages, snacks and Pet Pictures with Santa. ($5 donation to R.E.A.D.)

Learn More

New Client

    Owner Information

    (All authorized Owners and Agents must be at least 18 years old):






    Co-Owner Information


    Patient Information



    MaleFemale
    YesNo



    Referral



    YesNo


    Agent Information

    Other than the owners listed above, please specify any other persons to whom you give primary responsibility for the care of the patient.


    Agent 1



    Agent 2



    Informed Consent

    I understand that my veterinarian will need to communicate with the owners, or someone designated by the owners, prior to the treatment of my pet(s) in order to obtain informed consent. For purposes of obtaining consent, I direct my veterinarian as follows: (Choose one)

    Informed consent may be provided by:

    I further acknowledge that no guarantee has been made as to the results that me be obtained. I understand that complications may arise which cannot be predicted and that I will be held financially responsiveness for any veterinary medical care necessitated by complications, in addition to those previously requested. In accordance with WI Stat 35.93, VE 7.02, this statement serves to inform you, the client, that some services may be provided by a veterinary student, certified veterinary technician or an unlicensed assistant.

    Your signature for this agreement will be signed in person at our office on your first visit.


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