Clinic Policies

    New Client Request Form


    Thank you for considering Churchville Veterinary Hospital P.C.
    AT THIS TIME WE ARE NOT ACCEPTING NEW CLIENTS​

    Pet Owner Information

    Patient Information

     Patient #2 Information
    If you have more than two pets pets we will collect additional patient information from you at or before your pet's first visit


    ​YOUR DIGITAL SIGNATURE BELOW ACKNOWLEDGES THAT YOU HAVE READ AND AGREE TO ALL TERMS
    ​
    Upon request estimates will gladly be provided to you via email prior to your pet's appointment(s)
    ​ All fee's must be paid in full at time of service. 
    All of our patients are superstars! We would love to have your permission to take their picture for our medical records, social media pages and website. No personal information is ever shared. Do you give us permission to take photo(s) of your pet(s)?
    PLEASE EMAIL US YOUR PET'S PREVIOUS MEDICAL RECORDS
    ​     vet.churchville@gmail.com 

    Many veterinary practices across the United States and beyond are facing the challenge of having  limited licensed veterinary professionals while also being inundated with a stream of cases both urgent and non-urgent. Churchville Veterinary Hospital P.C. is taking remarkable efforts behind-the-scenes to balance these high demands for veterinary care with our day-to-day capabilities.
    Your patience and cooperation is appreciated.

    Thank you for choosing Churchville Veterinary Hospital P.C. If you have any questions, please don't hesitate to give us a call.

Hospital Forms
These can be printed, filled out and brought with you to your pet's appointment

Dental Options Form 

Please fill out this form prior to your pet's scheduled procedure/surgery.  You can either e-mail it to us prior or bring it with you.

CPR Consent Form

Please fill out this form prior to your pet's scheduled surgery.  You can either e-mail it to us prior to your appointment or bring it with you.

Small Mammal History Form

Please fill out this form prior to your first scheduled appointment.  You can either e-mail it to us prior to your appointment or bring it with you.