New Patient Form

I realize that no guarantee nor warranty can ethically or professionally be made regarding the results or cure of my pet.

I certify that I own and assume financial responsibility for all charges and fees (including attorney fees), for the above described pet(s). I do hereby consent and authorize STONEY POINTE PET HOSPITAL and its staff to hospitalize administer vaccinations, medications, tests, surgical procedures, anesthetics or treatments that the doctor may deem necessary for the health, safety and well-being of my pet while it is in their care.
If my pet(s) should injure itself in an escape attempt, refuse food, soil itself, become ill or die while in their care, I will hold the STONEY POINTE PET HOSPITAL free of any responsibility and/or liability in the absence of gross negligence. *Email and/or cell # required for pet’s notifications and reminders.

I understand there is a $25.00 fee for returned checks.

**FULL PAYMENT IS DUE WHEN SERVICES ARE RENDERED**