New Client Form

New clients, please also complete the New Patient, small animal or Equine form and contact the office to schedule an appointment.

717-529-0526

New Client Form

  • Please be as complete as possible.
  • Client Information

  • Emergency Information

  • Additional Information

  • Multi-species family

  • List or describe any major issues for you or your animal's multi-species "family" in the following areas.
  • Video/Photo/Testimonial Release

  • Optional: My signature confirms the consent to be video recorded or photographed. I can withdraw my consent at any time by submitting a written request. The recordings/photographs are for educational/advertising purposes &/or placed on our website or social media page. I will receive no compensation for my consent &/or use of said media. The identity of you and your animal will be kept confidential, unless you choose to be identified as part of a testimonial.
  • I relinquish any right to the recordings/photos and I understand that this media may be copied and used by Always Helpful Veterinary Services &/or Maximum Horse Power, without further permission. I hereby release Always Helpful Veterinary Services &/or Maximum Horse Power, and any of its associated or affiliated companies, their directors, officers, agents and employees from all claims of any kind on account of such use.
 

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