New Clients

Fill out the form below.

Please Note: All fields marked with * are required. If you have any questions, please feel free to contact us.

Personal Information

Address Information

Contact Information

**Your email address is strictly used for internal purposes and for communication directly with you. We send out your pet’s appointment notes/reminders, revised policies, internal promotions that would apply to you, inclement weather updates, estimates for surgical/medical services as well as surveys on how to improve our services.
We ask that your primary phone # be a cell phone number as we will text appointment confirmations, policies, special order notifications, etc. via text.

Other Information

Emergency Information

I grant permission to the additional following individual(s) (relative, friend, barn manager, etc.) to act as my agent if necessary where consent is required for emergency veterinary services for my animal(s) when I cannot be reached after a considerable effort or when I am away for a long period of time:

Emergency Contact #1

Emergency Contact #2

Payment Information

A mutual understanding and adherence of the financial protocol between the clinic and our clients is a vital part of a healthy professional relationship.

Please note that we are a paperless clinic and by default, all written communication including invoices will be sent to you through email. If another method is preferred, please inform one of our receptionists so that this can be noted on your account.

Payment for sales and services provided at our clinic can be in the form of cash, debit card, e-transfer, and credit card (VISA, MasterCard, and American Express).

Sales and services provided at client or stable premises can be placed on account. Payment, as noted with the above payment methods, is appreciated upon receipt of the invoice. Online banking is also accepted (add Central Veterinary Services as a Payee and have your account number, noted after your name on the invoice, ready).

If you would prefer to leave a Credit Card on account for us to process upon invoice completion, please inform our receptionist either in person or by phone and provide the necessary information. Please mention if you would like a maximum dollar amount noted, whereby we would contact you prior to charging your card if an invoice exceeded this amount. Your Credit Card information will be stored in our password-protected clinic software program on computers and a network with up-to-date security protection.

A payment plan alternative is available through the use of PayBright Financial Services or PetCard. Please speak with one of our receptionists or visit their website at or for more information.