East Marietta Animal Hospital
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    • Pet Care Team >
      • Dr. Diaz
      • Dr. Ferrall
      • Dr. Harp
      • Rena
      • Bobbi
      • Jill
      • Juliett
      • Kendall
      • Madison
  • Contact
  • New Patients
  • Pet Services
    • Medical Services
    • Anesthesia and Patient Monitoring
    • Dental Health
    • Surgical Services
    • Wellness and Immunization Programs
    • Preventive Services
    • Nutritional Counseling
    • Boarding and Bathing
    • Additional Services
  • Forms/Request Services
    • Prescription and Product Refill Request
    • Welcome Form
    • Request Appointment
    • Request Boarding
    • Boarding Pre-Check In
    • Boarding Pre-Check In And Doctor Exam
  • Online Ordering

New Client Welcome Form

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    Pet's Information

    MEDICAL AND VACCINE RECORDS - Once we receive your pet's medical and vaccine history from a veterinarian, rescue, shelter or breeder, we will be able to make an appointment for your pet.

    Web and Social Media Release

    East Marietta Animal Hospital has my permission to have my pet(s) photograph(s) posted on East Marietta Animal Hospital electronic media, including, but not limited to, promotional video, web pages, and social media such as Twitter, YouTube, and/or Facebook pages for the purpose of advertising.

    Treatment Authorization Electronic Signature

    I hereby authorize the veterinarian to examine, prescribe for, or treat the above described pet. I understand payment in full is due at time of service and I assume responsibility for all charges incurred in the care of this animal. ​Accepted forms of payment are cash, check (we do not accept counter or out of state checks), Care Credit, VISA, MasterCard, Discover or American express. There is a $30.00 fee for returned checks. A finance charge of $20.00 per month will be assessed on any portion of any unpaid balance. Also, I understand that a deposit may be required for treatment.
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  • Home
  • See what our clients are saying about us!
  • About
    • Pet Care Team >
      • Dr. Diaz
      • Dr. Ferrall
      • Dr. Harp
      • Rena
      • Bobbi
      • Jill
      • Juliett
      • Kendall
      • Madison
  • Contact
  • New Patients
  • Pet Services
    • Medical Services
    • Anesthesia and Patient Monitoring
    • Dental Health
    • Surgical Services
    • Wellness and Immunization Programs
    • Preventive Services
    • Nutritional Counseling
    • Boarding and Bathing
    • Additional Services
  • Forms/Request Services
    • Prescription and Product Refill Request
    • Welcome Form
    • Request Appointment
    • Request Boarding
    • Boarding Pre-Check In
    • Boarding Pre-Check In And Doctor Exam
  • Online Ordering