Client Information

Primary Contact(Required)
Do you want to receive text messages?(Required)
Secondary Contact
Do you want to receive text messages?
Pet Sitter, Family Member, etc.
Home Phone, Work Email, etc.

Pet Information

Please list all the pets you have in your household:(Required)

Policies and Acknowledgments

I acknowledge that I have engaged Martinez Animal Hospital for the care and treatment of my pet(s). I understand that while the clinic will provide the best possible care, there are no guarantees or warranties regarding the outcome of any medical procedures or treatments. I agree to assume full financial responsibility for all services rendered.(Required)
I grant Martinez Animal Hospital permission to take photographs or videos of my pet for promotional, educational, or informational purposes. I understand that these images may be used in print or digital media, including but not limited to the clinic's website and social media channels. I waive any rights to compensation or ownership of these images.(Required)
I agree to pay all charges for services provided by Martinez Animal Hospital upon discharge of my pet. Payments can be made by most major credit cards, Care Credit or cash.(Required)
A credit card processing fee of up to 3% will be applied to all transactions made using credit/debit cards. This fee will be itemized separately on your billing statement, and you will have the option to choose alternative payment methods if you wish to avoid this fee. Any price you are quoted is the “Cash Price” and does not include the processing fee.(Required)
I understand and accept the clinic's cancellation policy, which requires a minimum of 24 hours' notice for cancellations; otherwise, a cancellation fee may apply.(Required)
I acknowledge the clinic's late policy, which states that while efforts will be made to accommodate appointments, if I am more than 10 minutes late, Martinez Animal Hospital may not be able to provide services, and a $10 late fee may apply.(Required)
I also understand that Martinez Animal Hospital may require a deposit for certain services, and I am willing to comply with such requests.(Required)