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New Client Registration Form

Please fill out this form prior to your first visit. It may also be filled out in person. In that case, please arrive about 10 minutes early for your appointment.

Spouse or Co-Owner

Pet Information

Payment Policy

Full payment is due at the time of service. Acceptable forms of payment are: cash, personal check (from Washington state with proper identification), debit, VISA, MasterCard, and Discover cards. We also accept CareCredit, which may allow you to spread out your payments over time. Some CareCredit policies are at zero interest. You can apply for CareCredit prior to your visit (please follow the links on our home page), or in person when you arrive. Unpaid balances or returned checks are subject to returned check fees, interest and collection fees. Cancellation policy: Poulsbo Animal Clinic works by appointment only (we are happy to see you on an emergency basis during business hours if necessary, but appreciate a call before you arrive). We request 24 hours notice for changes or cancellations. Due to the number of missed appointments by some clients in the past, we may assess a cancellation fee. I have read and agree to the policies as stated above. I authorize Poulsbo Animal Clinic to treat my pet. I understand that I may request a written estimate at any time and agree that full payment will be made at the time of service.