Owner's Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Home Phone

Cell Phone

Which number is best to reach you? *

Home
Cell

Can you receive text messages? *

Yes
No

Email *

Add a Co-Owner? *

Yes
No

Name *

First

Last

Home Phone

Cell Phone

Previous Vet:

Previous Vet's Phone Number

Whom should we thank for referring you?

Pet Species *

Dog
Cat

Pet's Name *

Sex *

Male
Female

Neutered/Spayed? *

Yes
No

Breed *

Color *

Birthdate or Age *

Current Medications

Please bring and give any medical records/vaccine records to the receptionists to make copies.

Would you like to schedule an appointment? *

Yes
No

What day would you like to visit our hospital? *

What time of the day do you prefer? *

Morning
Afternoon

What is the reason for your visit? *

OFFICE POLICIES

To allow for ample time for all patients and surgical procedures, Craven Creek Vet operates primarily by appointment. We request all our clients be on time for scheduled appointments and procedures. If you are 15 minutes late to your appointment you may be asked to reschedule your appointment. We do take emergencies; however, these services may be subject to a higher fee schedule. For your convenience, we offer limited same-day appointments for urgent care sick patients - they fill up fast, so we recommend calling first thing in the morning.

For your protection and that of others, pets should be properly restrained by a leash or carrier upon arrival. If your pet requires special accommodations, please give us a call when you arrive so we can assist you and your pet.

If you must cancel an appointment, we ask for 24 hours’ notice. For surgical appointments, we ask for a 48-hour cancellation notice.

We accept cash, debit, or all credit cards. We also offer Care Credit or ScratchPay financing to help make the highest quality care accessible to all our patients.

We would be more than happy to fill your prescriptions or have your food orders ready for pick-up. Please call ahead or use our website to process refills. Please allow 24-48 hours for prescription refills. Special orders or controlled substances may require longer. We do not authorize online pharmacy requests by phone or fax. If you need a written prescription to be processed at the pharmacy of your choice, you will need to pick them up in person.

I hereby authorize the veterinarian to examine, prescribe for, or treat the above described pet. I assume responsibility for all charges incurred in the care of this animal. *

I have read and agree.

I understand that payment is ALWAYS DUE IN FULL at time of service. A deposit of 50% of the treatment plan may be required before treatments or hospitalization of your pet. I recognize that financial concerns should be discussed PRIOR to examination and treatment. *

I have read and agree.

Do we have your permission to share your pet’s image and story on our social media, website, and other forms of related media? *

Yes
No

I authorize my emergency contact below (other than myself) to pursue treatment if I am unavailable. Emergency contact must be an adult over the age of 18. *

I have read and agree.

Emergency Contact *

First

Last

Emergency Contact Phone *

Clear Signature

Date *

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New Clients

Thank You For Choosing Craven Creek Vet

Compassionate veterinary care in Powdersville, SC.

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Contact

Serving Powdersville, SC, and beyond.

Providing quality health
and pet care!

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