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Windy Hollow - Patient Intake Form

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    CLIENT INFORMATION
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    PAST HISTORY

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    OFFICE POLICIES


    To allow for ample time for all patients and surgical procedures, Windy Hollow Veterinary Clinic operates primarily by appointment. We also are available to see Walk-Ins and Emergencies, however, these services may be subject to a higher fee schedule. As such, we request all our clients be on time for scheduled appointments and procedures.
    For your protection, and that of others, pets should be properly restrained by a leash or carrier upon arrival.
    If you must cancel an appointment we ask for 24 hours notice. For surgical appointments we ask for 48 hour cancellation notice. A late cancellation or frequent cancellations may result in a fee being applied to your account.
    We accept cash, check, debit, or credit cards. We also offer Care Credit financing to help make the highest quality care accessible to all our patients.
    Windy Hollow Veterinary Clinic would be more than happy to fill your prescriptions or have your food orders ready for pick-up. Please call ahead with enough notice and we will have your order ready when you arrive.
    I hereby authorize the veterinarian to examine, prescribe for, or treat the above described pet. I assume responsibility for all charges incurred in the care of this animal.
    I understand that payment is ALWAYS DUE IN FULL at time of service. I recognize that financial concerns should be discussed PRIOR to exam and treatment.

    I agree to the Office Policy Terms

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    We love social media! Do we have your permission to share your pet(s)’ image and story on social media, our website & other forms of related media? Your name and personal information will never be shared. Simply check below to authorize this:
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    TREATMENT CONSENT

    I hereby authorize the veterinarian to examine, prescribe for or treat the above described pet(s). I assume responsibility for all charges incurred in the care of this animal. I understand that payment is always due IN FULL at time of service. I recognize that financial concerns should be discussed PRIOR to exam & treatment. The WHVC staff is happy to provide estimates.

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    Please call our office now to schedule an appointment.

    (413) 367-0062

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