New Client Form - Vet In Dayton | Twin Maples Veterinary Hospital

Skip to content

Home
Team
Services
Client Center
Forms
- Appointment Questionnaire
- New Client Form
Careers
What’s New
- Blog
- Cat’s Corner
Contact
- Location and Hours
fb
youtube
Call or Text: (937) 866-5949

New Client Formrobert-admin2019-10-23T07:58:40+00:00

New Client and Pet Information Form
Welcome to Twin Maples Veterinary Hospital. So that we may serve you better, please complete the following:

Client Information
Home Phone Number*
(This number will be used as your account number)
Owner's Name:*
First Last
Spouse/Co-owner Name:
First Last
Address
Street Address City ZIP / Postal Code
Work Phone Number
(include extension, if needed)
Cell Phone Number
Spouse/Co-owner Work Phone Number:
Spouse/Co-owner Cell Phone Number:
Email*
Would you like your reminders to be sent by
- Text
- Email
- Mail
How did you first hear of us?
Word of mouth? Google? Yelp? Yellow Pages? etc...
New Pet Information
Pet's Name*
Species*
- Dog
- Cat
- Other
If Other, enter species here
Breed
Sex
- Male
- Female
Neutered/Spayed
- Yes
- No
Coat color(s)
Age (Date of birth, if known)
Previous Veterinary Hospital
Doctor Preference
Does your pet have an appointment?
- Yes
- No
If so, what day/time?
If your pet has had previous vaccines, please bring the records to the appointment, or fax records to 937-866-5917
Payment for service will be by:
- Cash
- Check
- MC/Visa
- Discover
- ATM/Debit Card
- Care Credit
By submitting this form, you are accepting financial responsibility for this pet.

Design by

Twin Maples Veterinary Hospital

Call: (937) 866-5949

3646 Watertower Ln, Dayton, OH 45449

Careers

Boarding Policy

BOARDING POLICY

Scroll down to read the policy in its entirety.

We at Twin Maples Veterinary Hospital are happy to provide boarding service for our clients’ pets. You can be assured of proper handling and proper medical care if it should prove necessary, while your pet stays with us. We ask that owners call for reservations for their pets. Cage space is limited and calling at least a week ahead for normal weeks, and at least one month ahead for holidays will help ensure your pet’s visit. Twin Maples will do everything possible to provide the best possible visit for your pet. Please ask us any questions you may have regarding your pets stay.

PET PREREQUISITES

We prefer to board pets who are current patients of Twin Maples, however, if space allows, we will board pets who are not our patients. We require that all new pets be examined by one of our doctors prior to boarding at our regular fee to ensure that they are currently healthy and to evaluate their temperament. If a pet is ill on admittance, he or she will be treated and billed as a hospital patient. If a pet is deemed behaviorally unsuited for boarding, boarding will be declined.

VACCINE REQUIREMENTS

We require that all boarders be up to date on vaccines, including: distemper, parvovirus, rabies, canine influenza, and Bordetella (kennel cough) for dogs. For cats we require panleukopenia (feline distemper), feline rhinotracheitis, calicvirus, and rabies. Feline leukemia virus vaccine is recommended for indoor/outdoor cats. Pets must have completed all required vaccinations at least 10 days prior to boarding. Puppies and kittens must have completed their vaccination series at least 2 weeks prior to boarding and be at least 18 weeks of age. These requirements are designed to keep your pet as safe as possible from infectious diseases while boarding and to protect our debilitated or injured hospitalized patients from infection. We thank you for your understanding.

MEDICAL PROBLEMS

If your pet has a medical problem and you would like a doctor to evaluate during boarding, please inform the receptionist prior to or at the time of reservation so that she may schedule an appointment for examination. If your pet becomes ill during boarding, we will administer treatment to your pet at regular fees

ADMISSION AND RELEASE

Please bring your pet to the hospital at the previously scheduled time. The receptionist will confirm your date of return and the time for release, if known. If a special diet is needed, or if medications must be given, please bring these and inform the receptionist. Please ask any questions about fees before or at the time of admission. Our staff will be happy to quote our current fees. We ask that owners call before coming to the hospital to pick up their pets. We bathe all boarders prior to release at no charge (if they stay two nights), and your call allows us to ensure that your pet is clean and dry for release. We will not release boarders before 11:00 am without special arrangements being made at the time of admission. Boarders are not released until after noon on Saturdays and Sundays and we do not release boarders on the holidays we are closed.

PET CARE

Our boarders are housed in individual cages or runs. Housemates may be boarded together if space permits. Appropriate bedding will be provided for your pet. We ask that you do not bring in towels, blankets, or beds. We encourage some toys such as Kongs and the Cube and will fill them daily with a special treat for your pet. For the safety of your pet we do not allow rawhide bones or rope/string toys. Many pets will bury small toys in their bedding and these may inadvertently be thrown out. For this reason we cannot guarantee return of personal items. Feeding is done in the morning for adults, and twice a day for puppies and kittens, unless otherwise requested. CNM EN is the normally fed ration. If your pet requires a special diet, please bring it with you, or you will be charged an additional fee for the diet, if we have it available. Dogs are walked outside twice daily. Cats receive clean litter twice daily.

Have a question?

We're excited to introduce the ability to text us! Click the button below and our team will be happy to help answer your questions.

New Client and Pet Information Form

Client Information

New Pet Information