New Client Form

I do hereby give my authorization and consent to Double Oak Mountain Animal Hospital, and its associates, to perform any & all operations which are deemed necessary by them for the welfare of any animal placed by me in their custody. I agree to hold Double Oak Mountain Animal Hospital’s doctors and/or their associates harmless from any claim or loss arising out of this authorization. I direct this to be effective for the present and each subsequent admission of any animal placed by me in their custody, such authorization to be terminated only by delivery to DOMAH and/or their associates of written cancellation of this authorization. I, the undersigned, hereby promise and agree to pay in full for any and all professional fees at the time services are rendered. I understand that billing and interest charges may be accrued on any balance outstanding for more than 30 days, and assume responsibility to pay these charges in full if incurred. We accept MasterCard, Visa, American Express, Discover, Care Credit, check, and cash payments.

I authorize this hospital to release my pet’s medical information to other veterinary hospitals, groomers, and kennels upon my request. I authorize this hospital to release my phone number in the event that my lost animal is recovered by another individual. The hospital may use photos of my pet with or without my name and for any lawful marketing purpose, including print, publicity, advertising, digital, and social media content.

All animals that are seen, or kept under the supervision of Double Oak Mountain Animal Hospital are required to be up to date on Rabies, Bordetella, and Distemper vaccinations. In the event that my pet is not up to date on these vaccines I hereby authorize this hospital to administer them.