New Client

Abbott Animal Hospital
Serving Worcester County for more than half a century

		Home

		Pet Library

		About Us

		Forms

Appointment Request

Prescription Refill

Change of Address

		Other Features

		Links

		Contact Us

		Rabies Information

		Site Map

		K.N.O.W. Heartworms

New Client Check In

If you would like to register your pet, you can help us expedite your check in by submitting this form.

Thank you for your cooperation.

Please bring proof of rabies vaccination when you come to your appointment. Massachusetts law requires veterinarians to vaccinate all dogs and cats prior to release from the premises. Acceptable proof of vaccination is a certificate of rabies vaccination issued by a licensed veterinarian or copies of medical records clearly indicating rabies vaccination. Rabies tags are not proof of vaccination. We will gladly call other clinics to confirm rabies vaccination status if you cannot find your rabies vaccination certificate.

330.600: Proof of Vaccination Required at Certain Facilities

No animal hospital, veterinarian's office or boarding facility shall accept a dog or cat unless the owner or keeper of such animal shall show proof of current vaccination against rabies; provided however, that if such animal has not been so vaccinated or proof is not shown, the animal shall be vaccinated prior to being discharged if the animal's medical condition permits.

Amazon.com Widgets

Form - New Client

Name & Email (required)
First Name (required)	Last Name (required)

Address (required)
Street Address (required)


City (required)	State/Province (required)	Zip/Postal Code (required)
,

Daytime Phone (required)
Phone Type	Phone Number (required)

Evening Phone
Phone Type	Phone Number

E-Mail Address (required) :

Date of your confirmed appointment (required)

Pet's Name

Age: Years, Months

Type of Pet (required) :

Breed:

Sex:
Male
Female

Neutered/Spayed
Neutered
Spayed

Are your pets vaccines current?

Do you have pets medical records?

Medical records at another veterinary Practice?
Yes
No

Name of Former Veterinary Practice

May we request a transfer of records?
Yes
No

Would you like us to call you for your appointment

Reasons or conditions that prompted your visit?

Please list any additional pets here

TERMS OF SERVICE AGREEMENT - IT IS IMPORTANT TO READ
I understand, by indicating I agree and submitting this registration, that I am responsible for any charges incurred by my pet while in the care of the doctors at Abbott Animal Hospital and that charges are due and payable at the time of service, unless other arrangements are made in advance. I also give consent to Abbott Animal Hospital to vaccinate my pet for Rabies as mandated by Massachusetts Law unless I present proof of vaccination at the time of my ppointment. Any balance that is carried over a period of 30 days will accrue a monthly finance charge of 1.5% or 18% per annum.

I HAVE READ THE TERMS OF SERVICE AND: (required)
I Agree
I Disagree

The verification code below ensures the form is not submitted by a computer

Verification Code :

Enter the code you see in the graphic below in this box.
Your post will not be allowed if you do not type this in correctly.

Abbott Animal Hospital
21 East Mountain Street
Worcester, MA 01606
(508)853-3350

http://www.evetsites.com