New Client Registration Form

New Client Registration Form

  • Co-owner's Name & Contact #

  • Pet Information

  • Date Format: MM slash DD slash YYYY
  • AUTHORIZATION: I hereby authorize Healthy Pet Hospital & Grooming’s veterinarians to examine, prescribe for, or treat the above described pet(s). I assume responsibility for all charges incurred in the care of the animal(s) and I understand that all professional fees are due at the time services are rendered*. I understand and agree that in the event of default, to pay reasonable collection and/or attorney fees. I also authorize Healthy Pet Hospital & Grooming to photograph my pet for medical records and social media purposes.

Map & Directions

Healthy Pet Hospital & Grooming
3411 E. Chapman Ave.
Orange, CA 92869

Healthy Pet Hospital & Grooming  is conveniently Located in Orange just off the 55 Freeway at Chapman Avenue.

Forms Of Payment Available:

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