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Animal Clinic of Santa Maria
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New Client Registration Form

Thank you for considering our hospital as your pet’s provider of veterinary services. We are dedicated to maintaining the health of your pet and look forward to many future years together.

Please complete this form as fully as possible prior to your first appointment which will help expedite the registration process and give us valuable insight in providing optimal care for your pet(s). The required sections have a red * asterisk.
  • Owner's Name

  • Co-owner's Name & Contact #

  • Pet Information

  • Pet #2

  • Pet #3

  • We ask that our clients provide a minimum of 24-hour notice for appointment rescheduling or cancellation. If 3 or more appointments are missed in a 6-month period, we require a deposit for exam cost ($53) in advance for future appointment scheduling, which the provider has right to charge for any additional missed appointments.
  • Please note this does NOT confirm this date and time. This will be sent to the staff to see if this is available. You will be contacted for confirmation.
  • By entering your name below, I agree to pay in full for all treatments provided to my pet(s) by Animal Clinic of Santa Maria. I understand that all fees are due at the time of service. Any charges left unpaid will be sent to collections.
  • Date Format: MM slash DD slash YYYY

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  • Home
  • New Clients
    • New Client Registration Form
  • About Us
    • Team
    • Promotions
  • Services
    • Boarding Form
  • Pet Health
    • Pet Health Checker
    • Pet Health Library
    • How-To Videos
    • Pet Food Recalls
    • Product Recalls
    • News
    • Pet Insurance
  • Contact Us
    • Make An Appointment
    • Prescription Refill and Food Order Request Form
  • Rx Online Pharmacy