Step 1 of 3 33% All new clients will be requested to leave a $54 deposit at the time of scheduling an appointment. This deposit will be applied to the first visit. However, in the event of a cancellation with less than 24 hour notice, it will be forfeiting the deposit. No-showing an appointment will also result in a loss of deposit. If a cancellation or reschedule is needed, we request a minimum of 24 hour notice to have the deposit applied to a new appointment date or possible refund. Thank you for your understanding. We look forward to exceeding your expectations! Your team at Family Veterinary Care of Oakdale All new clients will be requested to leave a $54 deposit at the time of scheduling an appointment. This deposit will be applied to the first visit. However, in the event of a cancellation with less than 24 hour notice, it will be forfeiting the deposit. No-showing an appointment will also result in a loss of deposit. If a cancellation or reschedule is needed, we request a minimum of 24 hour notice to have the deposit applied to a new appointment date or possible refund. Thank you for your understanding. We look forward to exceeding your expectations! Your team at Family Veterinary Care of OakdaleOwner Name* Date of Birth* Month Day Year Co-Owner Name Date of Birth Month Day Year Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Address Home Number Work Number Cell Number* Co-Owner Work Number Co-Owner Cell Number Name of Previous Clinic Phone Military Yes No Senior Yes No Recommended by Whom? Place of Employment First PetSpecies* Pet InformationNameBreedMicrochip#Date of BirthColorSexSpayed or NeuteredDate of VaccinationsRabiesDA2PParvoCoronaBordatella Add RemoveDate of VaccinationsRabiesFELVENT-FVRCPFIP Add RemoveSecond PetSpecies Pet InformationNameBreedMicrochip#Date of BirthColorSexSpayed or NeuteredDate of VaccinationsRabiesDA2PParvoCoronaBordatella Add RemoveDate of VaccinationsRabiesFELVENT-FVRCPFIP Add RemoveThird PetSpecies Pet InformationNameBreedMicrochip#Date of BirthColorSexSpayed or NeuteredDate of VaccinationsRabiesDA2PParvoCoronaBordatella Add RemoveDate of VaccinationsRabiesFELVENT-FVRCPFIP Add Remove I/we hereby authorize the veterinarians to examine, prescribe for, or treat my pets (s). I/we assume full responsibility for all charges incurred in the care of this/these animal(s). I/we also understand that these charges will be paid in full at the time of release and that a deposit may be required for certain surgical treatments or other procedures.Type Signature PhoneThis field is for validation purposes and should be left unchanged.