160 Corporate Blvd., Indian Trail NC
(704)821-7040 Fax: (704)821-4692
Welcome to the Indian Trail Animal Hospital family - we are glad you are here!
At Indian Trail Animal Hospital, you will experience high quality up-to-date pet healthcare delivered by a caring and compassionate team that
makes partnering with you to improve the health of your pet and the strength of your bond our highest priority.
Our mission is to care for your family by nurturing the human-animal bond. Please let us know how we can fulfill our mission for your
family. Our Values:
Genuine relationships with your family and pets
Your time and commitment to your pets
The application of modern medicine to better serve your family
Training for our entire medical team, and sharing our knowledge with you
Thank you for taking the time to fill this form out as completely and accurately as possible.
Are you the: Owner Co-Owner Responsible Party
Owner Information: Co-Owner or Responsible Party Information:
Name: __________________________________ Name and relationship to owner: ______________________
Address: _________________________________ Address (if different): ________________________________
City/State/Zip: ____________________________ City/State/Zip: _____________________________________
Primary Phone: ___________________________ Primary Phone: ____________________________________
Secondary Phone: __________________________ Secondary Phone: __________________________________
Email: ____________________________________ Email: ___________________________________________
If other individuals are permitted to make medical and/or financial decisions for your pets, please list their name and
contact information here:
Contact preference (Please mark 1, 2, 3): Phone call Text message E-mail
How did you hear about us? ________________________________________________________________________
Should we share a referral discount with any specific person? _____________________________________________
I ASSUME RESPONSIBILITY FOR ALL CHARGES INCURRED IN THE CARE OF THIS ANIMAL. I ALSO UNDERSTAND THAT THESE CHARGES WILL BE
PAID AT THE TIME OF RELEASE AND THAT A DEPOSIT MAY BE REQUIRED FOR SURGICAL TREATMENT. I ALSO GRANT INDIAN TRAIL ANIMAL
HOSPITAL PERMISSION TO POST MY PET’S PICTURE, STORY, AND MEDICAL INFORMATION ON SOCIAL MEDIA.
Owner or Responsible Party Signature____________________________________ Date____________________
Must be at least 18 years old
Printed Name _____________________________
NEW CLIENT WELCOME FORM
Please help us enter accurate information by printing clearly.
Must be at least 18 years old.
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