New Client/Patient Form:

Welcome to the Best Friends Pet Clinic. To expedite your check-in process at our clinic, please fill out our new client/patient form online below. If you prefer, you can also print out the form and bring it with you to your pet's appointment. If you are unable to do either of these options, not to worry, you can fill out a paper form upon arrival at our clinic for your pet's scheduled appointment. For assistance, call us at 479-782-8113.

Owner's first and last name:

Additional owners first and last name: (This person is authorized to pick-up, drop-off, and/or pay for your pet.)

Full mailing address: (City, State, and Zip)

Primary phone number and additional phone numbers:(Please indicate who's number belongs to whom.)

Email address:

How would you like to receive reminders for your pet - via Text, via mail, or both?

How would you like our clinic to contact you if your pet is here for the day? Text or Phone Call?

Pet's name / breed / sex / age or DOB / spayed, neutered, or intact / approximate weight: (Please answer all questions.)

Pet's current medications, pet's previous veterinarian(s), and who referred you to BFPC:

Photo and Story Consent:

We love posting pictures of your sweet babies on our social media! Do we have your permission to share your pet's image and/or story on our clinic's social media? Your personal information will never be shared.

TREATMENT CONSENT:

* I hereby authorize the veterinarian to examine, prescribe for or treat my animals. I assume responsibility for all charges incurred in the care of this animal. I understand that payment
is always due IN FULL at time of service. I recognize that financial concerns should be discussed
PRIOR to exam and treatment. *

* I understand if fleas and/or ticks are found on my pet(s), they will be treated and I am responsible for the cost of treatment. *

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479-782-8113 (phone) | 479-782-0635 (fax)

bfpc595@gmail.com

4400 Rogers Ave. Suite C

Fort Smith, Arkansas 72903