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New Client Form

Save time during your first appointment. Complete your new client form online before your visit.

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New Client Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit.

Owner Information

Co-Owner Information

Previous Veterinary Clinic Information

Pet Information

Additional Pet Information

Online Pharmacy

Statement of Ownership

Clear Signature

Professional Fees are to be Paid at the Time Services are Performed

  • In admitting my pet(s) for diagnostics, treatment, or surgery, I authorize the veterinarians and support staff of Farmer's Veterinary Hospital to administer such treatment and/or perform such diagnostic or surgical procedures as deemed necessary
  • It is understood that an estimate of charges will be given upon request for services. No guarantee or assurance can be made as to the results that may be obtained for services provided.
  • I assume full financial responsibility for all charges incurred by my pet. I realize that these charges may exceed a given estimate if complications arise. I understand that I will be contacted prior to treatment, if possible, should complications occur.
For your convenience we accept cash, MasterCard, Visa, American Express or Discover Card. We also accept CareCredit and ScratchPay.
Clear Signature
We will do everything in our power to accommodate your schedule at all times. If you cannot make it to any appointments in the future, please call as soon as possible to reschedule or cancel the appointment. PLEASE NOTE that if you don't call ahead of time to reschedule or cancel more than 3 times in a 12 month period, you may be required to leave a non-refundable down deposit for future appointments. Removal of deposit requirement will be at the discretion of Farmer's Veterinary Management.
Peanut Law
  • In compliance with the Code of Virginia, we are required to inform you of hours of operation with a veterinarian in the building. Monday-Friday 9am-6pm. The office is closed Saturday and Sunday. In case of emergency, we would advise the patient be taken to an urgent care or emergency facility
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Social Media Consent

I hereby give Farmer's Veterinary Hospital permission to take photographs and videos of me and my pet for the purpose of posting on Farmer's Veterinary Hospital’s Facebook, Instagram, Indeed, and clinic website.
I hereby release and discharge Farmer's Veterinary Hospital from any and all claims arising out of use of the photos.
Clear Signature