• ALLANDALE VETERINARY HOSPITAL

    66 Caplan Ave , Barrie, Ontario L4N 9J2 (705) 733-1422 PATIENT and CLIENT INFORMATION SHEET Thank you for giving our hospital the opportunity to care for your pet. So that we may be better able to meet your needs, please complete the following:

    Owner Information

  • How did you become aware of our clinic? -

  • MEDICAL INFORMATION - (PLEASE FILL OUT COMPLETELY)-

  • PET INFORMATION-

    Pet One

  • Please remember to bring vaccine history with you upon arrival

  • Pet two

  • Please remember to bring vaccine history with you upon arrival

  • Pet three

  • Please remember to bring vaccine history with you upon arrival

  • Pet Four

  • Please remember to bring vaccine history with you upon arrival

  • PAYMENT POLICY:

  • Full payment is required upon rendering of services. Deposits may be required on major medical / surgical procedures, trauma cases and emergency work where hospitalization is required. We will gladly prepare a written estimate if you desire. We do not carry open accounts. Payment must be made in CASH, DEBIT CARD (INTERAC), AMEX, VISA or MASTERCARD. We regret that we are unable to accept cheques. If for any reason payment cannot be made today, arrangements may be made with the Hospital Supervisor PRIOR to seeing the doctor. To prevent the spread of infectious diseases and parasites, hospitalized animals must be current on all vaccines and free of internal parasites. I authorize Allandale Veterinary Hospital to provide vaccines and parasite control when needed.

    Signature of owner or authorized representative: __________________________________________________________
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