New Client Info

Park Veterinary Hospital offers our new patient form online so you can complete them in the convenience of your own home or office. Simply fill out the form below, and we will receive your submission electronically.

New Client Info

Client Information

Do we have your consent to place your pet(s) picture on our website or Facebook page? Any pictures taken will not be used for advertising purposes, will only be used for fun pictures on our website.

Pet Information

Number of Pets *

Pet 1

Dog/Cat *
Male/Female *
Spayed/Neutered? *
Microchipped?

Pet 2

Dog/Cat *
Male/Female *
Spayed/Neutered? *
Microchipped?

Pet 3

Dog/Cat *
Male/Female *
Spayed/Neutered? *
Microchipped?

Pet 4

Dog/Cat *
Male/Female *
Spayed/Neutered? *
Microchipped?
 

Previous Veterinarian

Authorization

Professional fees are to be paid at the time services are rendered. Park Veterinary Hospital is not in the business of advancing credit to its customer. All accounts will be billed monthly and all outstanding balances are due and payable when rendered. Any account which is not paid in full will be assessed a service charge of $7.50 or 1.5% of the unpaid balance, whichever is greater. If payment cannot be made in full Park Veterinary Hospital reserves the right to withhold your pet until payment is met at an additional charge of the nightly boarding rate. THERE IS A $350.00 SERVICE FEE FOR ANY ACCOUNT THAT MUST BE TURNED OVER TO OUR COLLECTION DEPARTMENT. In the event that suit is filed, venue will be Broward County, Florida. Furthermore, I agree that I will be held personally responsible for all costs associated with the collection of this account, including but not limited to: a collection agency fee and court costs. I also understand that all returned checks will be assessed a $35.00 service charge.

All prices are subject to change without notice. Estimates are available upon request.

Get the best care for your best friend.

Request an appointment online.