Thank you for giving us the opportunity to care for your pet. As an AAHA accredited hospital, our goal is to provide compassionate and thorough health care for cats and dogs through education and advanced medical care. You and your pet are our highest priority. We value your devotion to their health and well-being. In order that we may better serve you, please complete the below new client form.Here you’ll find everything you need about Bear Valley Veterinary Care Center and how we can help you. We have online forms for everything related to our Denver veterinarian clinic, along with what to expect at your visit. What to ExpectPayment OptionsTestimonialsServicesDownload & Print FormName* First Last Spouse/Other Caregiver Name First Last Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Cell #*Home #Work #Spouse Cell #Spouse Home #Spouse Work #Preferred number to contact* Cell Home Work Spouse preferred number to contact Cell Home Work Occupation*Employer*OK to call at work?* Yes No Emergency Only Email Address (This is so you can receive copies of your pet’s lab work, report cards, reminders, and occasional informational emails.)* Spouse Email Address Pet's Name*Breed*Color*Sex* Male Unneutered Female Unspayed Male Neutered Female Spayed Birthday or Approximate Age*How long owned?*Does your pet take any medications?Where obtained?* Pet Store Shelter Breeder Friend/Neighbor Date of last veterinary visit*Name/Phone of last Veterinarian*I authorize Bear Valley Veterinary Care Center to request previous medical care records from any/all previous providers. (initial)*Reason for leaving last veterinarian?*How did you hear about us? Google Search Facebook Event Sign/Drive by Referral From Family/Friend If referral, who may we thank?Bear Valley Veterinary Care Center is proud to be accredited by the American Animal Hospital Association (AAHA) for more than 25 years. For more information about our accreditation go to www.healthypet.com. Have you heard of AAHA?* Yes Yes, and it plays a role in my choice of Veterinarian No I authorize Bear Valley Veterinary Care Center to use photos of my pet on Facebook or other social media sites. (initial)*ALL FEES ARE DUE AT THE TIME THE SERVICES ARE RENDERED. Please review and sign financial policy. I authorize treatment of my pet by the staff and doctors of Bear Valley Veterinary Clinic and confirm that I am at least 18 years of age. (Agree by typing your name below).*Drivers License Number*Financial Policy Acknowledge each item by initialing, then sign at bottom.Payment is always due in full at the time services are performed*We cannot release hospitalized pets from the hospital, or release medications dispensed, until the final bill for hospitalization or the current patient visit has been paid.*We can not sell food, medications, or other items “on account”. We cannot extend further services or products to clients with outstanding balances. We do not extend credit or bill for services. All open invoices are sent to collections after 45 days.*We accept Visa, Mastercard, American Express, Care Credit, and Discover. Two forms of ID are required when you use Care Credit.*We accept cash payments and do not accept personal checks*We are happy to accept telephoned-authorized credit card payments when you are able to provide all of the necessary information including credit card number, expiration date, security code, and billing address.*We promote the use of Pet Insurance. Payment is due in full at the time services are performed, but we will be happy to keep claim forms in order to expedite your prompt payment from the insurance company.*Gift cards, vaccine programs and other services sold through the website are non-refundable.*Dog-walkers, pet-sitters, neighbors, and other alternate care-givers must accept financial responsibility on the above terms before we can accept your pet for medical care.*Due to the high demand of pets in need for our services, we require a credit card to be stored on file. In the event of a no show or cancellation within 24 hours of your appointment time, we will charge the card on file for the amount of the exam fee for the type of appointment on the schedule.*If you would like an estimate before services are performed, we’d be happy to provide one, but ultimately it is your responsibility to ask about the cost of services performed.*SignatureCAPTCHA Δ
