New Clients

Thank you for considering our hospital as your pet’s provider of veterinary services. We are dedicated to maintaining the health of your pet and look forward to many future years together.

CLIENT INFORMATION

Address(Required)












Is primary phone a:



How would you prefer we contact you?(Required)



We will gladly prepare a written estimate if you desire.  Please ask the receptionist or doctor.  PROFESSIONAL FEES ARE DUE AT THE TIME SERVICES ARE RENDERED.  We accept debit, VISA, MASTERCARD, DISCOVER, AMERICAN EXPRESS, AND CARE CREDIT.  If you plan to use a credit card or Care Credit, please provide your driver’s license to the receptionist to make a copy.

Do you have a preferred doctor you would like to see?
How did you first hear of our hospital?












To prevent the spread of infectious diseases and parasites, hospitalized and boarded animals must be current on all vaccines and free of internal and external parasites to enter our hospital for surgery, boarding, drop off or hospitalization.

I certify that I am the legal owner

I authorize Haines Road and EDGE Animal Hospital to use my pet’s pictures on social media.

I authorize Haines Road and EDGE Animal Hospital to release my pet’s records to other vets, boarding facilities, etc.

PET 1 INFORMATION

Spayed or Neutered?(Required)


PET 2 INFORMATION

Spayed or Neutered?


PET 3 INFORMATION

Spayed or Neutered?


Authorization