ParkView Animal Hospital

Phone: (727) 526-3137

3720 54th Ave N, St. Petersburg, FL 33714

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Client & Patient Registration Form

Client Information

Owner's Name
Co-Owner's Name
Address
Consent
Preferred Contact
Referred by
Records can be sent to parkviewanimal@yahoo.com

Patient Information

Species
Gender
Is your pet neutered or spayed?
Vaccine History
Has your pet had a rabies vaccine?
Would you like to add an additional pet?

Additional Pet #2

Species
Gender
Is your pet neutered or spayed?
Vaccine History
Has your pet had a rabies vaccine?
Would you like to add an additional pet?

Additional Pet #3

Species
Gender
Is your pet neutered or spayed?
Vaccine History
Has your pet had a rabies vaccine?

Consent Information

I consent to ParkView Animal Hospital posting pictures of my pet(s) on their webpage and/or Facebook.
All vaccine and due services reminders are sent by email or text, do you consent to receive these reminders?
Initial
Initial
Initial
Initial
I authorize the staff of ParkView Animal Hospital to render treatment to my pet(s) while in the hospital. I understand that in the event of any unusual or emergency circumstances the staff will make every possible attempt to contact me, if time permits, before treatment. I also understand the charges incurred are to be paid in full at the time of service and a deposit may be required prior to hospitalization.
MM slash DD slash YYYY
Clear Signature
Payment types accepted at ParkView Animal Hospital: Debit cards, all major credit cards (Visa, Mastercard, Discover, and American Express), CareCredit, cash, and checks. Cardholders must be present or have a credit card pre-authorization form on file.
This field is for validation purposes and should be left unchanged.

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ParkView Animal Hospital

Phone: (727) 526-3137 Address: 3720 54th Ave N, St. Petersburg, FL 33714

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COVID-19 Information

Dear Patients,

While many things have changed the past few months, one thing has remained the same: our commitment to you and your family’s safety. To help keep you safe we have added a few changes in our daily routine.

  • If you have an appointment our office may communicate with you beforehand to ask some screening questions. You’ll be asked those same questions again at time of appointment.
  • We are practicing social distancing for the safety of all of our staff and clients. We are asking that only one family member come into the hospital with your pet(s). You are required to wear your own mask covering nose and mouth.
  • Upon arrival, please call our office and wait in your car for instructions. No clients are allowed in the office unannounced. Our waiting room is closed. Once the exam room is available, we will call you on your cell phone for you to come into the hospital with your pet.
  • We will try to keep to schedule, but due to cleaning protocols, it may take us a little longer than normal between clients.
  • You have the option to come into the hospital with your pet or wait in your car while we bring only your pet into the hospital for examination. If you elect to wait in the car, the doctor will call you after she examines your pet and discuss your pets health with you.
  • If you are here for medication or pet food orders, please call our office and we will bring all medication and food orders to your car.
  • We look forward to seeing you! We are happy to answer any questions you may have about our new procedures to keep you and every client safe in our practice. Please call us if you have questions. 727-526-3137

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