providing Animal Care in Foley, AL For Over 25 Years
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251.955.5900
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Home
About Us
Our Facility
Meet The Doctors
Meet The Staff
Testimonials
Services
Surgery & Internal Medicine
Emergency & Critical Care
Wellness Care
Specialists & Telemedicine
Laser Therapy
Ultrasound
Digital Radiology
Dental Care
Microchipping
Animal Acupuncture
Bathing
Soft Paws
Luxury Boarding
Boarding
Forms
Patient/Client Information
Surgery Consent Form
Dental Consent Form
Heilmeier’s Bed & Biscuit Boarding
Blog
Contact Us
Menu
Home
About Us
Our Facility
Meet The Doctors
Meet The Staff
Testimonials
Services
Surgery & Internal Medicine
Emergency & Critical Care
Wellness Care
Specialists & Telemedicine
Laser Therapy
Ultrasound
Digital Radiology
Dental Care
Microchipping
Animal Acupuncture
Bathing
Soft Paws
Luxury Boarding
Boarding
Forms
Patient/Client Information
Surgery Consent Form
Dental Consent Form
Heilmeier’s Bed & Biscuit Boarding
Blog
Contact Us
Patient/Client Information Form
Date
Email
Owner's Name
Spouse/Other
Address
City, State, Zip Code
Home Telephone
Work Phone
Cell
Employer Name & Address
Spouse/Other Employer & Address
Time to Call About Pet
Phone Number to Call About Pet
EMERGENCY Contact Name
EMERGENCY Contact Phone Number
We will gladly prepare a written estimate if you desire. Please ask the receptionist or doctor.
PROFESSIONAL FEES ARE DUE AT THE TIME SERVICES ARE RENDERED.
How do you intend to pay?
Cash
Credit Card
How did you hear about our hospital?
Individual
Hospital Sign
Yellow Pages for Location
Website
Other
ANIMAL MEDICAL CENTER IS A FLEA FREE FACILITY. ALL ANIMALS ENTERING THE KENNEL WILL BE GIVEN A $6.50 CAPSTAR AT OWNER'S EXPENSE. TO PREVENT THE SPREAD OF INFECTIOUS DISEASES AND PARASITES, HOSPITALIZED AND BOARDED ANIMALS MUST BE CURRENT ON ALL VACCINES AND FREE OF INTERNAL AND EXTERNAL PARASITES.
I authorize the doctor to provide vaccines and parasites control as needed for my pet. I give permission to have my pet's likeness and/or picture and medical story posted on social media. I assume responsibility for all charges in the care of this animal. I also understand that these charges will be paid at the time of release and that a deposit may be required for surgical treatment. I understand that if I do not pay for services as agreed, I agree to pay all costs of collection.
Owner or Responsible Party
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