Please Note: We will be closing early at 1 PM on Tuesday, December 24th and will be closed on Wednesday, December 25th in observance of Christmas!

New Client Registration Form

BOOK APPOINTMENT

Please complete this form before your visit.

Your Name *

First

Last

Cell phone number *

Additional name you would like on your account

Additional cell phone number you would like on your account

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

By adding your email, you can set up appointments and Rx refills online

Place of Employment *

Employment Address *

Address Line 1

Address Line 2

City

State

Zip Code

Work Phone

Fees for all services are due at the time services are rendered. Personal checks are accepted with ID and when approved by Certegy. Visa, MasterCard, Discover, Care Credit, and cash are also acceptable forms of payment. We do not offer in-house payment plans, but you may inquire about Care Credit, a no-interest financing option. We are also happy to provide printed estimates upon request of diagnosis.

I grant permission to Woodland Veterinary Hospital, its representatives, and employees the right to take pictures of my pet(s) to use for marketing and promotional purposes. I authorize Woodland Veterinary Hospital to copyright, use, and publish these photographs in both print and/or electronically. I agree that Woodland Veterinary Hospital may use such photographs of my pets with or without a first name and last initial (i.e.: Fluffy R.) for any lawful purpose including for example such purposes as social media content, publicity, illustration, advertising, and website content. *