Online Client Forms

We know your time is valuable, so we’ve made it easy to take care of important paperwork before your visit. Whether you’re a new client joining our Community Veterinary Hospital family or need a medication refill, our online forms simplify the process so you can focus on what matters most: your pet.

New Client Form

Welcome to Community Veterinary Hospital! To help us get to know you and your pet before your first visit, please complete our New Client Form. This form allows our team to gather your contact information, your pet’s medical history, and any specific concerns you’d like to discuss during your appointment.

New Client Form
First
Last
Preferred Title:
Preferred Pronouns
Address
Address
City
State/Province
Zip/Postal
Preferred Contact Number

Employer Information

Address
Address
City
State/Province
Zip/Postal

Personal Identification

Secondary Owner Information

Name
Name
First Name
Last Name

Other Emergency Contact

Name
Name
First Name
Last Name

Pet Information

Is your pet current on its vaccinations?
Species
Sex
How did you hear about us?

Authorization

By electronically signing and submitting this form, you agree to the terms outlined below as well as the Community Veterinary Hospital Terms of Use and Privacy Policy. I, the undersigned owner or authorized agent, consent to the examination, treatment, and care of my pet(s) by the veterinarians and staff of Community Veterinary Hospital. I authorize the veterinarians to diagnose, prescribe, and treat my pet(s) as needed, and I may request a written treatment plan and estimate at any time with the understanding that final costs may vary. Any pet not picked up within the timeframe required by Sec. 1834.5 of the California Civil Code shall be considered abandoned and handled according to that law. I accept full financial responsibility for all services provided, including medications, laboratory testing, diagnostics, hospitalization, and surgery, and I understand that payment is due in full at the time services are rendered. Deposits may be required for certain procedures, and while the clinic does not extend internal credit, payment plans can be arranged through CareCredit or credit card with prior approval. Checks are not accepted as a form of payment, and I agree to pay any collection or legal fees incurred in the event of nonpayment. In the event of a medical emergency when I cannot be reached, I authorize the veterinarians to provide any care deemed necessary to preserve life and relieve suffering unless I have provided alternate instructions in writing.

Prescription Refill Request

If your pet needs a medication refill, you can request it easily through our Prescription Refill Form. Once submitted, our team will review your request, confirm your pet’s prescription details, and notify you when it’s ready for pickup.

Request a Refill