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4500 NE Cornell Road, Hillsboro, OR 97124
503-648-1643
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New Client Form
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Our Practice Management Software can only accept one email address, so please give us only the best email address to reach you.
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May we call you at work if necessary?
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Co-Owner's Employment
Work Phone
May we call you at work if necessary?
Yes
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**We respect your privacy. Your email will be used only to contact you regarding your pets. It will not be sold or distributed. You will receive an email with login instructions for Pet Portals, our free online service allowing you to check your pet’s reminders and request refills or appointments.
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I have read and understand
How did you hear about our hospital? Please be as specific as possible. For client referrals, whom may we thank?
We'd love to make your pet a star on our social media! We share cute photos with your pet’s first name only.
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I approve Frontier Veterinary Hospital to share photos/videos of my pet
I decline sharing photos/videos
All professional fees are due at the time services are rendered. We will gladly prepare a cost estimate upon request (please ask the doctor or receptionist). Methods of payment include: Cash, Visa, MasterCard, American Express, Discover, Money Order, and Care Credit. As owner or agent for the pet(s) described on the following page, I certify that I have read and agree to the above financial policy, and that I am at least 18 years of age. I assume financial responsibility for all services rendered, and I understand that any accounts over 30 days past due will be subject to a monthly interest fee.
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I have read and understand
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Please introduce us to your pet(s)!
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Cat
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Color
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Male or female?
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Male
Female
Is this pet spayed or neutered?
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Previous Veterinarian/Veterinary Hospital
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Any prior illnesses or surgeries we should know about?
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Any allergies we should know about?
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Additional Pet, if applicable.
Pet's Name
Date of birth or age? Is this actual or estimated?
Species
Dog
Cat
Other
Breed
Color
Male or female?
Male
Female
Is this pet spayed or neutered?
Yes
No
Previous Veterinarian/Veterinary Hospital
Any prior illnesses or surgeries we should know about?
Any allergies we should know about?
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What's Next
1
Call us or schedule an appointment online.
2
Meet with a doctor for an initial exam.
3
Put a plan together for your pet.
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