Client Information Form - Sandia Animal Clinic

Please fill out this Client Information form and the Patient History form, and a member of our staff will call you to schedule your appointment.

Alternatively, you can print and fill out these forms and bring them with you to your appointment.

If this is an urgent matter or an emergency, please call our office during regular business hours or contact an ER.

Client Information

Name(Required)

First Last

Pet's Name(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone Number(Required)

Other Phone Number

Email(Required)

Co-owner/Other Contact

First Last

Type of Appointment(Required)

Who may we thank for referring us to you?

Email/Text SMS Approval: By accepting, you consent to receive email and/or SMS text messages from us. Message rates vary; not all carriers are covered. Standard message and data rates apply. You may update your preference anytime by notifying our staff verbally or by replying CANCEL/STOP to any text you receive from us.(Required)

Decline

Photo/Media Release Approval: By accepting, you consent to the potential use of your pet’s photograph and name on our social media, website, and/or promotional material. Your name and personal information will be kept confidential and you will not receive compensation for useof your pet’s likeness if it is used.(Required)

Decline

Welcome to Sandia Animal Clinic!
Phone: (505) 299-9533 | Email: frontdesk@sandiaanimalclinic.com | Web: sandiaanimalclinic.com

Update your information: Please keep your account updated with current address, phone number(s), and email address. This information is important so we can contact you. If we fail to ask for your current information, we will certainly not be offended if you remind us!

Cancellation policy: We require a minimum of 24 hours for exams and 48 hours for surgery. Deposits are nonrefundable if you do not cancel your pet’s procedure.

No-call, No-show: All no-call, no-show appointments will be charged $50.00.

Treatment plans: Please do not hesitate to ask for a treatment plan, which covers the costs you may incur while your pet is being treated. Always make sure we provide a treatment plan for any surgeries or dentals that are scheduled. Estimates are valid for 30 days. We don’t want you to have any surprises!

Refills: Please give a 24-hour notice when requesting refills of medication and 7 days for prescription food. We require time to have doctors check pets’ records and approve refills. We will do our best to have refills ready the next day, as we hate to have you wait. You may call in a refill OR request refills on our website sandiaanimalclinic.com under “ORDER REFILLS” located at the top. Online refill requests eliminate waiting on hold and allows you to place an order anytime day or night!

Payments: Full payment is due at time of service. We accept Visa, Master Card, Discover, American Express, Care Credit, Scratch Pay, and cash. In the event of an open balance, a finance fee of 1.5% will be charged on the unpaid balance.

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