Fees: LaPaw Animal Hospital is a payment-at-time-of-service facility. We accept cash, checks, VISA, American Express, MasterCard, and Discover, and CareCredit. Please discuss any financial issues prior to any treatment or service. Thank you.

Oregon Trade Regulation 646.639. Section N

By accepting services at LaPaw Animal Hospital, the client agrees to pay all collection costs, interest, attorney fees, and any other charges arising out of this account should LaPaw Animal Hospital, pc, place any outstanding indebtedness that has been due for 90 days or more, or refusal to pay for previously agreed upon services, with a collection agency, the amount will be doubled to cover the collection costs.

Please also be aware that LaPaw Animal Hospital sees clients on an appointment basis. If appointments are missed 3 times, then you'll be charged for an appointment. Missed appointments not only affect LaPaw Animal Hospital but also affect other clients too. Thank you for understanding.

Unless otherwise noted, we will always copy/fax/mail a copy of your pet's records to any requested veterinarian, insurance company, or others with a valid request. A copy fee will apply to all charts over 20 pages long.

Occasionally, we take photos of pets and will put them into their medical record. Sometimes, a pet is especially interesting or cute and we will post on Facebook or our website. If you DO NOT want us to do so, please initial below.

Initial here if you DO NOT want us to use photos of your pet.

Signature *

Date *

How did you hear about LaPaw Animal Hospital? *

Location/Saw Us
Friend/Client
Online/Website
Other

If a friend/client, please name

If other, please specify

Owner's Name *

First

Last

Pet's Name *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Primary Phone Number *

Secondary Phone Number

Species *

Canine
Feline
Ferret
Other

If other, please specify species *

Breed *

Sex *

Male
Male Neutered
Female
Female Spayed

Birthdate *

Color *

New Client Form

New Client Form

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