New Client Form

How did you hear about us? (please select the answer that best reflects your introduction to Sleepy Hollow Animal Hospital)

Neutered/Spayed

Neutered Spayed None

Are your pets vaccines current?

Yes No Not Sure

Do you have your pets medical records?

Yes No Not Sure

Medical records at another veterinary practice?

Yes No

Name of former Veterinary Practice

Phone Number of former Veterinarian

Appointment Information

Reasons or conditions that prompted your visit?

Special requests or conditions

Please list any additional pets here

Preferred Method of Contact

Please Read

I understand, by indicating I agree and submitting this registration, that I am responsible for any charges incurred by my pet while in the care of the doctors at Sleepy Hollow Animal Hospital and that charges are due and payable at the time of service, unless other arrangements are made in advance.

Any balance that is carried over a period of 30 days will accrue a monthly finance charge of 1.5 percent or 18 percent per annum. Any balance that I leave unpaid will be forwarded to Sleepy Hollow Animal Hospital's collection agency, and will incur a 25 percent collection fee for which I am liable, in addition to monthly finance charges.

I have read this statement and -

I Agree

I consent to receive SMS text messages from Sleepy Hollow Animal Hospital. Msg&data rates may apply.

I Agree

Sleepy Hollow Animal Hospital may post photos of your pet on our social media or website to be featured as our “patient of the day” or similar.

Yes No

Start Your Veterinary Journey With Sleep Hollow Animal Hospital

SHAH New Client Form

Pet Information

Appointment Information

Please Read