Primary Owner's Name *

First

Last

Email *

Primary Phone *

Secondary Phone to Reach Primary Owner

Do you agree to receive text messages from Bay Animal Hospital? *

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By checking this box, you consent to receive informational and/or promotional text messages from Bay Animal Hospital at the number provided, including messages sent by the autodialer. Consent is not a condition of purchase. Message & data rates may apply. Message frequency varies. Unsubscribe at any time by replying STOP. Reply HELP for help. Privacy Policy.

Who else is authorized to make decisions about your pet's healthcare?

Secondary Owner's First Name

Secondary Owner's Phone

Relationship to primary owner

If other, please specify *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

How did you hear about our hospital? *

Please list *

Pet's Name *

Species *

Breed *

Coat Color(s): What does your pet look like? *

Estimated Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Yes
No

What is the microchip number?

Do you have a second pet? *

Yes
No

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Coat Color(s): What does your pet look like? *

Estimated Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Yes
No

What is the microchip number?

Do you have a third pet? *

Yes
No

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Coat Color(s): What does your pet look like? *

Estimated Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Yes
No

did (dog, your

What is the microchip number?

Do you have a fourth pet? *

Yes
No

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Coat Color(s): What does your pet look like? *

Estimated Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Yes
No

What is the microchip number?

Do you have a fifth pet? *

Yes
No

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Coat Color(s): What does your pet look like? *

Estimated Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Yes
No

What is the microchip number?

Do you give Bay Animal Hospital permission to take photos of your pet that may be posted on our social media? *

Yes
No

Don't Miss Out! Download our PetDesk mobile app and follow us on Facebook and Instagram for important updates and pet health tips.

We look forward to having a great relationship! Bay Animal Hospital's Protocols: please read the following carefully.

-If you are unable to make a scheduled appointment, we ask that you notify our office at least 24 hours in advance via phone or email.

-If no attempt is made to cancel within 24 hours of the appointment, a $35 fee will be required before scheduling your next visit.

-If you miss a scheduled appointment without notice, a $35 fee will also be required before booking your next visit.

-If you arrive more than 15 minutes past your scheduled appointment time without contacting our office, your appointment will need to be rescheduled for the next available date.

-As the primary owner of the pets on this account, you assume financial responsibility for all approved services provided to the pet(s) on this account.

-Payment is due at the time of service, and a deposit may be required for extensive treatment plans.

At Bay Animal Hospital, we vow to treat every client and patient with care and compassion. In return, we kindly ask that our clients treat our team with the same kindness and respect. Thank you.

*

I have read and accept the above policy.

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Signature *

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Don't Miss Out! Download our PetDesk mobile app and follow us on Facebook and Instagram for important updates and pet health tips.

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