New Client Form

APPOINTMENT

Thank you for giving Woodland Hills Pet Clinic the opportunity to care for your pet(s). To ensure the best care possible, please fill out this form completely. We’ll reach out with any questions.

Client's Name *

First

Last

Email *

**Your email address is strictly used for internal purposes and for communication directly with you. We send out revised policies, inclement weather updates, estimates for boarding/medical services as well as surveys on how to improve our services.

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Cell Phone *

We ask that your primary phone # be a cell phone number as we may text reservation confirmations, reminders, policies, etc via text.

Emergency/Alternate Phone

Spouse/Partner

Spouse/Partner Phone

Please list all pets that should be active on your account. Only list pets that currently live in your household. Please include each pet's name, species, breed, sex, if they are spayed/neutered, color, and age.

You know your pet is a SUPERSTAR & we agree! Can we post your pet’s photo on our social media pages?

I approve for Woodland Hills Pet Clinic to post and use all pictures/videos taken of my pet.
I do NOT authorize for Woodland Hills Pet Clinic to post or use any pictures/videos taken of my pet.

If you do not authorize for your pet’s picture to be included in our marketing materials/venues we may still use a picture of your pet in our patient records for our internal identification only.

I understand that financial responsibility for services rendered are payable at the time of discharge. I have reviewed the treatment plan and estimate provided to me by Woodland Hills Pet Clinic staff and my signature below indicates my approval of the treatment plan. *

I have read and understand

Signature *

Today's Date *

Message