NEW CLIENT FORM

Client Information

Pet Information #2

Pet Information #3

How did you hear about us?

We love to share pictures & videos of our adorable patients!

If we were to take a picture of your pet we would like your permission to use it in our social media content, promotional materials and/or publicity efforts. These photographs may be used in publications, print ads, direct-mail pieces, electronic media (e.g. video, Internet, Web site) or other forms of promotion in perpetuity without remuneration or further consent. Your pet’s name may be shared but your identifying information would not be.

Client Consent

I agree that the information provided is accurate to the best of my knowledge. I hereby authorize Erin Trailside Veterinary Services to provide medical care/treatment for my pet(s) from this date forward. I understand that I am responsible for all charges incurred for the care of my pet(s) and that payment is due at the time services are rendered.