Skip to content
Login
Register
Forgot Password
Existing Client Log In:
Email:
Password:
Arlington Animal Hospital in Saskatoon, SK
Contact Us
3010-b Arlington Avenue
Saskatoon, SK
S7J 2J9
(306) 955-8387
Search Lifelearn:
Search Site:
New Clients
What to Expect
New Client Form
Patient History Form
Anesthesia Information & Consent Form
Additional Services Form
About Us
Team
Take A Tour
Services
All Services
Additional Services Form
Pet Health Checker
Contact
New Client Form
Home
» New Client Form
Please take a moment to fill out the following information. It will help us provide the best possible care for your pet. Thank you!
Name
First
Last
Address
Street Address
Address Line 2
City
ZIP / Postal Code
Phone
*
Work Phone
Cell Phone
Email
Do you consent to receive reminders and other information pertinent to your pet via e-mail?
Yes
No
How would you prefer to receive reminders for your pet?
E-mail
Mail
Phone
How did you choose our hospital?
Location
SaskTel Yellow Pages
Internet
Personal Reference
Holistic medical care
Other
If you chose "Other" above
If personal reference, whom may we thank?
Name of your Pet Insurance Provider
Payment in full is due upon completion of services. What method of payment do you prefer?
Cash
Debit Card
Visa Card
Master Card
Medicard
Hospital policy is that we do not offer payment plans. If financial help is needed the hospital recommends the use of Medicard to provide necessary financing.
If, in case of an emergency, we cannot get a hold of you, who is authorized to give permission for treatment?
Name #1
First
Last
Phone #1
Name #2
First
Last
Phone #2
If we are unable to get a hold of you or your representative, is Arlington Animal Hospital authorized to provide emergency services (including CPR) for your pet at your cost? Please check one option.
Please check one option for the above statement.
Yes
No
Yes, up to $
(ln most circumstances $600 will allow us to stabilize your pet until we are able to contact you or your representative)
Yes, unlimited amount
Please sign your name below if you would like this option.
No. Please sign here to authorize euthanasia
If you choose not to decide on one option the staff at Arlington Animal Hospital will humanely end your pet's suffering if above situation should arise.
Owner's Signature
*
Date
*
Date Format: MM slash DD slash YYYY
Share
Print this page
Email this page to a friend
Share this page on Facebook
Share this page on Twitter
Share this page on Google Plus