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Bendigo Pet Vets - Mobile Veterinary Clinic - New Client Form

We're excited to welcome you to our practice. To help get to know you and your pet, we ask that you complete this new client form so that we can best meet your requirements during the visit.


Client Details

PET DETAILS

Select sex





PET MEDICAL HISTORY

Is your pet microchipped?



REASON FOR VISIT

Please select your reason for visit





PET HEALTH INSURANCE

HOW DID YOU HEAR ABOUT US?

Please select how you found out about our practice.








FRIEND REFERRAL

REFER A FRIEND PROGRAM

Receive a $10 credit on your account for every friend/colleague you successfully refer to us (not redeemable for cash)

OTHER COMMENTS

TERMS & CONDITIONS


  1. I am the owner of the above described Pet or have authorisation from the owner to consent to treatment.
  2. I accept financial responsibility of the veterinary services my Pet receives.
  3. I understand and accept that payment is due at the time of service.
  4. I understand that Bendigo Pet Vets do not do personal accounts and if there are money concerns these will be raised with a staff member prior to accepting treatment.
  5. I understand that I can seek financial assistance through specific veterinary loan companies such as OpenPay and Vetpay.

Signature


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