Please complete this form before your first visit. We look forward to meeting you!
Please complete this form carefully and thoughtfully. All information is kept confidential and allows us to provide the best service for your pet needs.
Please allow us to verify/photocopy your driver's license, state-issued identification card, or military identification card. If you do not wish to provide this information, we require prepayment for all office visits, surgeries, procedures, and products. Your SSN/DL numbers are NOT entered into our software.
By signing below, I hereby authorize Northwood Hills Animal Hospital to examine, prescribe for, or if necessary, perform surgery upon my pet(s).