New Client Form

OWNER INFORMATION

Owner's Full Name *

Phone Number *

Address *

City *

Province *

Postal Code *

Email Address *

ALTERNATE CONTACT INFORMATION

Name of any other person over the age of 18 you would like registered to this account who can take responsibility for (name-animal)'s treatments.

Full Name

Relationship

Phone Number

PET INFORMATION

Tell us about your pet(s) *

	Name	Breed	Colour	DOB/Age	Sex	Microchip #	Insurance Company
1.
2.
3.

Please list anything we should know about your pet (e.g. medical history, behavior, aggression)

PRIVACY, COMMUNICATION & TERMS OF BUSINESS

Aspen Animal Hospital respects your privacy and is committed to protecting your personal information. We collect, use, and disclose personal information only as necessary to provide veterinary care, maintain accurate medical records, manage your account, and communicate with you regarding your pet's health and treatment.

Essential Communication Consent

To provide veterinary care for your pet and manage your account, Aspen Animal Hospital may contact you by phone call, email, and text message (SMS) using the contact information you have provided. These communications may include appointment reminders, treatment and surgical instructions, laboratory and diagnostic results, prescription and special order notifications, medical updates regarding your pet's care, payment and account information, product recalls, and other information necessary for patient care and clinic operations. Phone calls, emails, and text messages are essential methods of communication and are required for us to provide veterinary services.

I acknowledge and consent to receiving essential patient care and account communications by phone call, email, and text message (SMS). *

Optional Promotional & Marketing Communications

From time to time, Aspen Animal Hospital may send emails containing clinic news, educational pet care information, special promotions, newproducts or services, and MyVetStore updates. These promotional communications are separate from essential patient care communications and are never sent by text message.

Please select your preference *

Yes, I would like to receive promotional emails and newsletters
No, I do not wish to receive promotional emails and newsletters

Photography & Video Consent (Optional)

Aspen Animal Hospital may take photographs and/or videos of your pet for use on our website, social media pages, and in other promotional or educational materials. We will not disclose any personal or confidential information about you or your pet's treatments.

Please select your preference *

Yes, I consent to Aspen Animal Hospital taking photographs and/or videos of my pet
No, I do not consent

Client Agreement

By signing below, I acknowledge that I have read and understood Aspen Animal Hospital's Terms and Conditions of Business and the communication, privacy, and consent policies outlined above.

Signature *

Date *

Today

Security Question *

I HAVE READ AND UNDERSTOOD THE PRIVACY POLICY *