Call today: (650) 348-8022
Peninsula Avenue Veterinary Clinic- San Mateo  Burlingame, CA- Animal Hospital
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  • HOME
  • About us
    • Our Team
    • Hospital Tour
  • Services
  • Pet Health
    • Health Conditions Library
    • Dog Wellness
    • Cat Wellness
    • Pet Poison Hotline
    • Pet Travel
    • Pet Nutrition
    • Behavior / Training
    • Pet Insurance
    • Dental Care
    • Allergies in dogs and cats
    • "How To" Videos
  • Forms
    • Client Registration
    • Check in / History
  • PHARMACY
  • Blog
  • Contact us
  • Request an Appointment
  • NEW CLIENT
  • PRICING

    Peninsula Avenue Veterinary Clinic New Client Form
    ​

    The State of California requires us to report your birth date if your pet ever is prescribed a controlled substance
    Used to send vaccine reminders and lab results
    Name of co-owner or co-guardian.


    BY SUBMITTING THE FORM I AGREE TO THE TERMS BELOW:
     I am the  owner or authorized agent of the pet identified herein, hereby consent to the examination of my pet by staff veterinarians at Peninsula Avenue Veterinary Clinic  and after consultation with me to prescribe for, treat, hospitalize, anesthetize or perform surgery on my animal. I understand that some risks always exist with anesthesia and/or surgery and that I am encouraged to discuss any concerns I have about those risks with my attending veterinarian before the procedure is initiated. Should some unexpected life-saving emergency care be required, PAVC staff has my permission to provide such treatment and I agree to pay for such care

    I understand that an estimate of the costs for veterinary services will be provided to me and that I am encouraged to discuss all fees attendant to such care before services are rendered and during my pet's admission. I agree to assume financial responsibility for the balance of ALL services rendered on a cash, credit card, or check basis at the time my pet is discharged from the hospital. In the event of an open balance, I agree to pay a monthly billing and financing fee equal to 1.5% of the unpaid balance. I AGREE TO PREPAY THE FIRST OFFICE CALL FOR MY PETS ($85). I UNDERSTAND THAT IF I CANCEL WITHOUT 24 HOURS NOTICE, THAT I FORFEIT THIS FEE.
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