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New Client Registration Form

Thank you for considering our hospital as your pet’s provider of veterinary services. We are dedicated to maintaining the health of your pet and look forward to many future years together.

Please complete this form as fully as possible prior to your first appointment which will help expedite the registration process and give us valuable insight in providing optimal care for your pet(s). The required sections have a red * asterisk.

  • Owner's Name

  • Co-owner's Name & Contact #

  • Pet Information

  • Date Format: MM slash DD slash YYYY

  • Personal Information Consent

    At Silver Springs Animal Hospital we respect your right to privacy and will not collect, use or disclose any personal information regarding you or your pet without your consent. We will only disclose personal information about you in circumstances where it is beneficial to the continued good health of your pet. Please indicate below whether or not you will permit us to disclose personal information in those situations.

  • Payment Policy

    We will not refuse treatment to alleviate pain and suffering. If you are unable to meet our payment policy , you just notify us prior to treatment. Payment is due when services are rendered. Hospitalization cases will not be released without payment. We accept CASH, DEBIT, MASTERCARD & VISA.