New Client / Pet Registration

South Huntington Animal Hospital West Virginia WV Ohio OH Kentucky KY Tri-State Tri State pet pets dog cat Laura Fulks DVM Jan Ball DVM Catherine Robinson DVM Huntington Ashland Ironton Wayne Lavalette Chesapeake South Point Proctorville Barboursville Cabell Animal Clinic Animal Hospital Veterinary Veterinarian Vet Care Hill's Purina Science Diet Bayer Merial Novartis Animal Health Zoetis Pfizer Merck Veterinary Elanco Animal Health Surgery Surgical spay neuter dental shelter Fulks Ball Robinson Veterinary Technician Vet Veterinary Care Animal Clinic Hospital Animal Medical Center Laser Therapy pharmacy radiology x-ray digital lab laboratory animal veterinary health Laura Fulks

If you've scheduled an appt, when is it?

Consent and authorization *

By clicking this box and submitting this form, you agree to the following: South Huntington Animal Hospital, PLLC, requires a valid driver's license or government issued photo ID to activate your status as a client. Also, South Huntington Animal Hospital, PLLC, requires payment in full at time services are rendered. This establishment does not extend any type of in-house credit or offer payment plans. For your convenience, cash, all major credit cards, and Care Credit are accepted. Personal checks from a long-standing bank account may be used. Upon request, any and all charges and potential charges can be discussed before your pet is treated. The owner has the right to question, discuss, and refuse any service and or treatment, even if recommended. Estimates are available upon request. Owner accepts full financial responsibility for any services provided (including any additional costs and fees, legal and otherwise, associated with the collection of any debt).

Color: *

Animal Type (choose one) *

Pet Name: *

Alternate Phone *

Primary pet food given: *

Breed: *

Reason for this visit:

Best Phone Number *

Who may we contact for medical records?

Owner(s) Name(s): *

Address *

Please list any health problems / concerns

Birthdate:

NEW CLIENT / PET REGISTRATION

If you are registering more than one pet, please submit a separate form for each one. We humbly appreciate the trust you place in us by allowing us to care for your loved ones. THANK YOU!

Sex (choose one) *

Age: *

Your Employer:

Expert care for the life you share.

South Huntington

Animal Hospital, PLLC

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