Call: 352-686-0671

Text: 352-686-0671

3449 Deltona Blvd, Spring Hill, FL 34606

Appointment

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Home
About Us
Services
Online Pharmacy
Client Center
Join Our Team
Contact Us
Book Appointment



A note to our clients

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We hope you understand that, despite our best efforts, appointment wait times may be longer than usual due to the high demand our hospital faces on a daily basis. Please be patient and kind with our staff during your pet’s appointment and, for those requesting prescription refills, please give us a call one week in advance.

Please remember we are working extra hard during these unprecedented times and your friendly cooperation means the world to us!

New Client Form

Name: Animal Medical Clinic of Spring Hill
Address: 8101 Forest Oaks Blvd, Spring Hill, FL, 43560, United States
Telephone: 352-686-0671
Price range: $

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit.

Book Appointment

New Client Form

Financial Policy and Authorization

ALL PAYMENTS ARE DUE AT TIME OF SERVICE, WE DO NOT DO PAYMENT PLANS OR TAKE POST DATED CHECKS.

Personal Checks: The Animal Medical Clinic reserves the right to refuse a personal check from any new client.

Authorization: By sending this form, you hereby authorize the staff of the Animal Medical Clinic to examine and treat the described animal, and understand that payment for services rendered is required at the time the animal is discharged from the clinic

Name(Required)

First Last

Email(Required)

Primary Phone(Required)

I consent to receive SMS text messages from Animal Medical Clinic of Spring Hill. Msg & data rates may apply. Reply STOP to opt-out.(Required)

Yes

Secondary Phone

Address(Required)

Street Address Address Line 2 City State ZIP Code

Who else is authorized to make decisions about your pet's healthcare?(Required)

First Last

Phone

How did you find out about our hospital? If you were referred by someone, who should we thank?(Required)

Pet's Name(Required)

Species (dog, cat, etc.)(Required)

Breed(Required)

Age/Date of Birth(Required)

Sex(Required)

Male

Neutered Male

Female

Spayed Female

Does your pet have a microchip identification?(Required)

Yes

What is the microchip number?(Required)

Do you have pet insurance?(Required)

Yes

Who is your pet insurance provider?(Required)

Payment is due in full at the time that services are performed. If being admitted into the hospital, we cannot begin the care of your Pet until you have confirmed your desire to do so by 1) signing the client consent & estimate form, and 2) leaving an initial deposit of 50% of the upper end of the estimate. This is the only way that we have of knowing for certain that you want us to proceed with the care of your Pet. We accept Cash, Visa, MasterCard, Discover, and CareCredit payments. We neither extend credit, nor bill for services. All open invoices are sent to collections after 45 days unless prior arrangements are made.(Required)

I have read and accept the financial policy.

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New Client Form

New Client Form

Financial Policy and Authorization

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