New Client Form

Welcome to Paradise Animal Hospital! Thank you for giving us the opportunity to care for your pet. Please help us meet your needs better by taking a moment to complete this information form.

New Client Form

* Indicates required field

Owner Name *

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Last

Address *

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City

State

Zip Code

Country

Phone Number *

Email *

Patient Information

Patient Name *

Species *

Breed *

Age *

Color *

Sex *

Is you pet microchipped? If so, Microchip number: *

Previous Veterinary Hospital *

Current Medications: *

Special Diet *

To prevent the spread of infectious diseases and parasites, we recommend animals to be current on all vaccines. Pets with fleas will be treated with an oral flea medication on admission, and the prescription price will be included in the invoice. I authorize administration of vaccines and parasite control as needed for my pet(s). *

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Last

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We will gladly discuss cost of services and/or prepare a written estimate for recommended procedures. Professional fees are due at the time services are rendered. Deposits may be required for pets being admitted. We accept cash, checks, debit cards, Visa, Mastercard, American Express, Discover, and Care Credit. We charge a $30.00 fee for returned checks.