New Patient FormNew Patient Form Download PDF Owner* Date* Mailing Address (street # & name, city, postal code)* Email* Significant Other Phone* Work Phone Other Phone Pet Insurance? Yes/No* If Yes, Name of Insurance Company & Policy # How did you learn about our clinic?* Sign OutsideYellow PagesFacebookRecommendationWebsiteNews PaperOther If recommended, by whom?*Number of Pets Dogs Cats Other (Specify)Pet #1 Species*DogCatOther Pet's Name* Pet's Breed* Pet's Color* Pet's Age* Pet's Sex*UndeterminedFemale IntactFemale SpayedMale IntactMale Neutered Pet's Current Medications* Reson/s For Requested Visit* Please List A Few Days & Times You Are Available For The Appointment* Pet #2 SpeciesDogCatOther Pet's Name Pet's Breed Pet's Color Pet's Age Pet's SexUndeterminedFemale IntactFemale SpayedMale IntactMale Neutered Pet's Current Medications Reson/s For Requested Visit Please List A Few Days & Times You Are Available For The Appointment Pet #3 SpeciesDogCatOther Pet's Name Pet's Breed Pet's Color Pet's Age Pet's SexUndeterminedFemale IntactFemale SpayedMale IntactMale Neutered Pet's Current Medications Reson/s For Requested Visit Please List A Few Days & Times You Are Available For The Appointment ATTENTION NEW CLIENTSAll new clients are required to pay a $88 deposit at the time of booking. This deposit amount will be applied to the invoice total at the end of the appointment.These bookings are subject to a 24-hour notification of cancellation period, or the client forfeits the deposit.In the event the client arrives late to their appointment, they will be rescheduled for a future visit, if available. Should this happen at the next appointment, the client forfeits their right to any future bookings.If two (2) no-shows occur, the client forfeits their right to any future appointment bookings.CANCELATION POLICYOur goal is to provide timely care to all our patients and to respect not only the veterinarian’s time, but the constraints of a tightly booked schedule. If you must cancel your appointment, we request a call, email, or text at least 24 hours before your pet’s appointment. This allows us to accommodate other patients who may need prompt medical care.Please mark this box to confirm you have read the statement above.*A NOTE TO ALL CLIENTSPlease have medical records from all previous vets sent to the clinic email: info@sagecreekanimalhospital.caWe need these records sent in as soon as possible.You may also fax them to: 204-255-1244Payment Options For Deposit: In-person with cash, debit, or credit | By Phone with credit | Online - using the Online Payment button on our homepage Δ