top of page

Patient Information/Registration

To provide the highest quality care and maintain efficiency for our patients currently in the hospital, all new client inquiries must be submitted through our online intake form. We are no longer able to establish new patient charts via phone calls, voicemails, emails, or walk-in requests.

​

The intake form allows us to collect complete and accurate medical history, records, and contact information so our team can properly review your pet’s needs before scheduling.

​

Next Steps:

  1. Complete the required intake form on this page

  2. Upload all relevant medical records and images

  3. Our team will review your submission and contact you with next steps. Please be patient with us as we work through the form submissions. 

​

Please note: Incomplete submissions will delay review and scheduling.

This system allows our medical team to remain focused on patient care while ensuring every case receives the attention it deserves.

Please complete all sections to avoid delay in processing. 

Patient Registration

Please fill out the following form completely. Incomplete submissions will delay form processing and scheduling.

CLIENT INFORMATION

What is you physical home address? PO Boxes not accepted.

Multi-line address

PET INFORMATION:

Species
Dog
Cat
Sex
Male
Female
Reproductive status
Intact
Spayed/neutered
Date of birth (estimated if unknown)
Month
Day
Year
Rabies Vaccination Status: (if your pet is due for a rabies vaccine, you may obtain this with your primary care veterinarian or a local vaccine clinic such as Hamlett Spay & Neuter; having a current rabies vaccine will avoid a scheduling delay.)
Up to date
Due for a rabies vaccine
Does your pet have labwork within the past 3 months? (If there are abnormalities on the most recent bloodwork, we may require that you recheck/follow up with your primary care veterinarian.)
Yes
No

PLEASE READ THE FOLLOWING STATEMENTS (seriously, please actually read them - they're not too long!)


I, the undersigned, hereby authorize the examination and treatment for my pet. I understand that the treatment of the patient will be conducted with due care and in accordance with the prevailing standards of competency in Veterinary Medicine. I understand that I will be provided with a quote for the recommended treatments and that I am liable for the full payment of the final treatment cost at the time services are rendered. I understand that the final cost of treatment may vary from the quotation and that I will be informed of any additional medications and/or procedures that may be deemed necessary to proceed with the treatment of my animal and that I am liable for the full payment of the same. Springs Veterinary Dentistry uses an AI assisted program to streamline note-taking and to ensure medical records are complete and accurate in a timely fashion. The use of the Digitail AI software is not optional. I understand that by signing this form, I am agreeing to permit use of this software for my appointments.


To provide high-quality dental care at an affordable cost, our practice operates on a procedure-focused model. This means that the veterinarian is dedicated to patient care and anesthesia throughout the day and is not available for in person consultations or face-to-face discussions. All patients receive a pre-anesthetic evaluation, and the doctor will contact you directly by phone if any significant findings, concerns, or treatment decisions arise during your pet’s procedure. Our trained medical team is available to communicate with you regarding your pet’s care before and after the procedure. By choosing our practice, you acknowledge and understand that our model differs from full-service or concierge-style veterinary clinics, and that direct consultation time with the doctor is strictly limited in order to maintain efficiency and affordability.


By signing below, this is also my commitment that I will pay for this animal's treatment on the day of treatment.  I understand that credit is not available and that Springs Veterinary Dentistry is making a commitment to do the best they can for me and my pet. I will conduct my business with all staff members and associates of Springs Veterinary Dentistry with respect, patience, and courtesy.


By signing below, I confirm that I am the owner of the aforementioned animal and have the authority to sign as such.

“By typing my full name above, I am providing my legal electronic signature and agree to the terms outlined in this form.”

bottom of page