775-683-9255 valleyvetclients@gmail.com

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New Client Form

Welcome to Valley Veterinary Clinic!

We are accepting new clients! We need you to provide medical records from your previous veterinarian and complete our new client form. We suggest you request those records to be emailed to you, so you have your own copy, then print a copy for us. Our new client form is on our website for you to complete and submit or print. We will make your appointment once we have those two pieces of information from you.

There are two ways for you to share your information with us:

1. You may complete the digital version of our New Client Form below and then click SUBMIT.
Your information will be forwarded electronically to our clinic.
OR
2. You may use the PDF version by clicking the DOWNLOAD PDF to Print button and then complete the printed form by hand. Please bring the completed PDF form with you for your pet’s first appointment.

DOWNLOAD PDF to Print

Name *

First

Last

Email *

Phone *

Alternate Phone

Address *

Address Line 1

City

State

Zip Code

How would you prefer to receive reminders? *

Emailed (recommended)
Text (recommended)
Snail Mail

Who shall we thank for your referral?

Add a spouse or approved secondary owner? *

Yes
No

Name *

First

Last

Email

Phone

Address

Address Line 1

City

State

Zip Code

I authorize treatment and/or service for any animal I bring to Valley Veterinary Clinic. I agree to pay for all charges at the time services are rendered for my pet(s). I certify that I am the primary owner of the pet(s) listed in this form. I authorize that the secondary owner has the authorization to sign for any treatment(s) and settle any balance for my pet(s). I will inform Valley Veterinary Clinic of any abnormal symptoms my pet(s) may be having at the time of check in at each appointment. I understand that the staff of Valley Veterinary will put my pets’ health first and foremost, and that in the incident a medical related reaction or incident occurs, I do not hold Valley Veterinary responsible. I have read and understood all above provisions of the Client Agreement with Valley Veterinary Clinic. *

I have read and understand.

Patient Information

Name *

Breed *

Species *

Canine
Feline

Age/D.O.B. *

Color/Markings *

Sex *

Male
Neutered Male
Female
Spayed Female

Any known reactions to medications or vaccinations? *

Yes
No

Please explain. *

Add another pet? *

Yes
No

Name *

Breed *

Species *

Canine
Feline

Age/D.O.B. *

Color/Markings *

Sex *

Male
Neutered Male
Female
Spayed Female

Any known reactions to medications or vaccinations? *

Yes
No

Please explain. *

PAYMENT TERMS & AGREEMENT: Payment in full is required at the time services are rendered. You may pay with one of the following: Cash, check (current clients), credit cards (VISA®, MasterCard®, and American Express®. Valley Veterinary Clinic does not provide in-house billing. If you need more time to pay a large bill, you may apply for a payment plan through CareCredit®, ScratchPay®, or VetBilling®. Your credit history will determine whether you qualify for a payment plan. Ask one of our staff members for assistance if you wish to apply for a payment plan. 50% of the estimate for cost of treatment plan is required as a deposit at the time of admission for all surgery, hospitalization, dentistry and emergencies, unless the client has a payment plan in place. *

I have read and agree to the terms above.

Signature *

Date *

Website

We love helping the pets and their people of Reno, NV.

At Valley Veterinary Clinic, we value the relationships with our clients and patients. Our team goes above and beyond to provide the best care possible for every pet that walks through our door.

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Location

9255 Lemmon Drive
Reno, NV 89506
Click here for directions.

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Contact Us

P: 775-683-9255
E: valleyvetclients@gmail.com

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Hours

Mon - Fri: 7:30 AM - 4:30 PM
Sat - Sun: Closed

Request an appointment online!

Current clients can request an appointment online by clicking the "APPOINTMENT" button. If you are a new client, please call us at 775-683-9255 for your first appointment.

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