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Laboratory
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Stance Analysis
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Ultrasound, Echo & Endoscopy with Dr. Ludlow
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Annual Client Form & Hospital Policies
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Admit & Non-Anesthetic Release
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Blog Center
A 10-year reflection
Acupuncture & TCVM A Natural Approach to Pain Relief? Pain
Rosie's Story
Ear cleaning with Dr. Couch
Separation Anxiety in Dogs
COVID-19 and the Effects on East-West Animal Hospital and the Veterinary Community
Healthy Mouth, Healthy Pet
Grain-free diets and your dog
Vaccines and your pet
Puppy Strangles
Pruritis: Itching and scratching in dogs
Fear Free Fun Visits!
Pet Insurance
Hills recalling can dog food
Cat Friendly Festivities
New /2023 Annual Client Form & Hospital Policies
We ask that this form be updated annually to keep our records current.
*
Indicates required field
Owner's Name
*
First
Last
Secondary Owner's Name
*
First
Last
Primary Email
*
Secondary Email
*
Primary Phone Number
*
Phone Type
*
Select One
Cell
Work
Phone Number
*
Phone Type
*
Select One
Cell
Work
Address
*
Line 1
Line 2
City
State
Zip Code
Country
County of Residence
*
For existing clients - Have you gained or lost any furry family members?
*
How did you hear about us?
*
Do your pet's have a Wellness Plan?
*
Choose 1
Yes
No
I'd like more information
Do your pet's have Pet Insurance for accident/injury/illness?
*
Choose 1
Yes
No
I'd like more information
Our appointment policy
Please arrive on-time to your scheduled appointment. Late arrivals cause schedule delays for those patients who arrive promptly at their appointment time.
Late arrivals will be worked into the schedule if time allows, a Late Appointment fee may be charged.
If you are significantly delayed, you may be asked to reschedule your appointment to another day or on a walk in basis.
Cancellation Policy/No Show Policy
We understand there may be times when you miss an appointment due to emergencies or obligations with work or family. Nevertheless, we encourage you to call at least 24 hours prior to your appointment to cancel. EACH TIME A PATIENT MISSES AN APPOINTMENT WITHOUT PROPER NOTICE, ANOTHER IS PREVENTED FROM RECEIVING CARE.
Therefore, EAST-WEST ANIMAL HOSPITAL reserves the right to charge a fee of
$72.00
for a missed appointment without prior notice of 24 hours. This fee will be payable by statement or at your next scheduled visit.
This also applies to appointments being rescheduled 3 or more times.
Appointments for specialty services may required payment prior to scheduled service.
As a courtesy, we agree to confirm your appointment to your primary phone number from one to three days before your scheduled appointment. When you give us a 24 hour notice, your reserved time can be made available to another patient.
Thank you for understanding the value of our cancellation policy and forms fee policy to each of our patients.
Payment Policy
We will gladly prepare a written treatment plan of services. All professional fees are due at the time of services are rendered. In cases of extreme medical or surgical procedures where payment in full may be difficult at discharge, we accept major credit cards, or can establish a payment arrangement through
CareCredit
or
ScratchPay
in advance of treatment.
By submitting this form, you agree to abide by the appointment, cancellation, and payment policies.
Please acknowledge with full name
*
Date
*
Submit
Thank you for completing this form to keep our records current!
Home
COVID-19 Appointment Procedures
About
Veterinarians
Team - Techs & Assistants
Team - CSRs
Join our Team!
Services
Services
Acupuncture & TCVM
>
What to expect with TCVM
Types of Acupuncture Techniques
Behavior
Dental Care
>
What's a Dental Grade?
Products to Help Prevent Dental Disease
Other Dental Conditions
Laboratory & Diagnostics
>
Laboratory
X-ray / Radiographic Diagnostics
Microchips
MLS Laser Therapy
Modified Vaccine Protocol
>
Titers & Medical Exemption Letters
Stance Analysis
Surgery
Ultrasound, Echo & Endoscopy with Dr. Ludlow
Wellness - Preventative Care Plans
Client / Patient Center
Client Center
>
Annual Client Form & Hospital Policies
Pet & Pet Parent Social Media Agreement
Payment Options
Patient Center
>
Pet Information
Pre-Visit Questionnaire (PVQ)
Behavior Questionnaires
Admit & Anesthesia Release
Admit & Non-Anesthetic Release
Fear Free
Contact
Resources
Blog Center
A 10-year reflection
Acupuncture & TCVM A Natural Approach to Pain Relief? Pain
Rosie's Story
Ear cleaning with Dr. Couch
Separation Anxiety in Dogs
COVID-19 and the Effects on East-West Animal Hospital and the Veterinary Community
Healthy Mouth, Healthy Pet
Grain-free diets and your dog
Vaccines and your pet
Puppy Strangles
Pruritis: Itching and scratching in dogs
Fear Free Fun Visits!
Pet Insurance
Hills recalling can dog food
Cat Friendly Festivities