• Client Information

    Thank you for giving us the opportunity to care for your pet(s). To allow us to become better acquainted, please fill out the following form.
  • Providing your email address and cell phone number allows us to make sure your pet gets the preventative care that they need. Vaccination and other reminders are sent electronically via text and email. We also send health alerts and periodic bulletins.
    Please check ALL that apply.
  • *NAME/PHONE# OF FRIEND/RELATIVE NOT IN HOUSEHOLD
  • Authorization

    I, the undersigned owner or agent of the owner, certify that I am at least 18 years of age or older, and do hereby authorize West Ridge Animal Hospital veterinarians and technicians to examine my pet and administer treatment as is considered necessary for my pet’s condition. An estimate with care options can be discussed with me prior to any diagnostic treatments.

    In life threatening situations, stabilizing care may be instituted immediately upon arrival without an estimate. We will gladly prepare a written estimate if you desire; please ask Doctor or receptionist. Unless prior arrangements have been made, ALL PROFESSIONAL FEES ARE DUE AT THE TIME SERVICES ARE RENDERED. We accept MasterCard, Visa, Discover, and American Express. We also accept Care Credit and Scratch Pay, and extended service fees may apply. There will be a $25.00 service charge for any check returned unpaid or credit card declined. Accounts after 30 days are subject to a 21% APR or $9.00 monthly billing fee, whichever is greater. By signing below, you authorize us to contact you by any or all of these methods, phone (home, work, cell), email, mail or text message and I accept these billing terms in the event of non-payment.

  • Date Format: MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.