new client registration

please complete the form below

    PRIMARY CONTACT

    SECONDARY CONTACT INFORMATION

    PET INFORMATION

    Name (required)

    Breed (required)

    Age (required)

    Species
    If other, describe.
    CanineFelineOther

    Sex
    Male, IntactMale, NeuteredFemale, IntactFemale, Spayed

    Current or previous vet offices your pet was seen at

    MEDICATIONS/SUPPLEMENTS

    If your pet is on any medications, please list drug names, dose, and how often they are administered, or write none (required)

    If your pet is taking any supplements, please list supplement names, and how often they are taken, or write none (required)

    Does your pet have any known medication allergies?
    If yes, please describe
    NoYes

    FEAR-FREE APPROACH
    We would like to do anything we can to reduce your pet's fear, anxiety and stress.

    Any tips or tricks to reduce your pet's fear, anxiety or stress while visiting us?

    MESSAGING AGREEMENT

    I consent to receive SMS text messages from Folsom Ranch Veterinary Hospital. Message & data rates may apply. Reply STOP to opt out.

    COMMUNITY AGREEMENT (required)

    More veterinary professionals than ever before feel that their mental and physical health is called into question during their shifts and in their day to day lives. Inappropriate and hostile treatment of veterinary professionals is on the rise in hospitals across the country. Our team members and their safety and well-being are a top priority at FRVH. While vet visits can be stressful, please also respect that under no circumstances will poor treatment of our team members be acceptable. You and your pet will be treated with the utmost respect and compassion that can be delivered at a veterinary hospital, and in return we ask that you commit to proper and courteous treatment of our team-members. By checking the box, you acknowledge the importance of this expectation and commit to this expectation at all times. Thank you for being our partners in making this hospital, and more importantly this profession, a safer experience for all.

    CONSENT (required)

    I am over 18 years of age and am the authorized owner and-or guardian for the aforementioned patient. I authorize Folsom Ranch Veterinary Hospital and Urgent Care (FRVH) to perform treatment/procedure(s) on my pet(s) as recommended by FRVH's Veterinarians and employees. I was informed of the reasons for the treatment and or procedure(s), along with the expected benefits and risks involved. I confirm that by signing below, I understand the inheritable and sometimes unforeseen risks associated with veterinary care and release all liability, without exceptions, from Folsom Ranch Veterinary Hospital (FRVH) while treating my pet(s). I understand that payment is required for all services at the time they are rendered unless prior arrangements have been made with hospital management. I understand that deposits may be required prior to certain procedures. In the event that a refund is due and the original payment is a credit card, the refund will be posted against the original credit card. Once medications are dispensed, they cannot be returned. To ensure smooth scheduling, we require a deposit after two late cancellations (less than 24 hours' notice) or no-shows within a 12 month period. The deposit, equal to the exam fee for doctor's appointments and $25 for technician appointments, must be paid at scheduling and will go toward the exam with no extra charges. If you cancel with more than 24 hours' notice, the deposit remains valid for rescheduling. FRVH utilizes a scribing service to enhance the accuracy and quality of your pet’s medical records. This service involves audio recording of your pet’s appointments, only while FRVH staff is present, to support thorough clinical documentation. By signing below, you consent to the recording of these visits and the secure sharing of these recordings solely for the purpose of improving clinical documentation and care.

    MEDIA CONSENT (required)
    I authorize FRVH to use pictures and/or video of my pet(s) for learning or marketing purposes. Consent will apply to all future pets added to this account unless and until I provide a written revocation of that consent.

    YesNo

    SIGN BELOW (required)

    Make sure to submit the Client Registration form before adding additional pets