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New Client/Patient Information Online Form

New Client/Patient Information Sheet

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.

Our goal and policy is to treat our clients as we would treat our families, and to treat our clients’ pets as though they were our own. Our clients and patients are the heart of our practice and the reason that we are here. At all times our clients and patients will be treated with respect, dignity, and compassion. Being of service to our clients and patients is the definition and the mission of our practice.
  • Owner's Name

  • Co-owner's Name & Contact #

  • Pet Information

  • The Carroll County Veterinary Clinic may or may not use such photographs of me and/or my pet with or without my name and for any lawful purpose, including, for example, such purposes as publicity, illustration, advertising, and Web content.

    We will need a copy of your driver's’ license for our records please. PAYMENT IS REQUIRED AT THE TIME OF SERVICE. We accept VISA, MASTERCARD, DISCOVER, AMERICAN EXPRESS, CARE CREDIT, CASH AND CHECK. WE DO NOT BILL. Failure to pay a bill or passing a bad check will result in legal action. Place of venue will be Carroll County, Maryland. There will be a $25.00 return check fee added to your account for any check that is returned. The person signing the check and/or this document is responsible for all legal cost.