top of page

클라이언트 양식

New Client Form

귀하께서 애완동물의 건강, 수술 및 살롱 서비스를 위해 저희를 선택해주셔서 기쁩니다. 첫 방문 전에 아래의 신규 고객 양식을 작성하여 제출해 주십시오.

Why did you choose East Lake Veterinary Hospital? (choose as many as apply):
About your pet:

You signature below and submission of this form indicates that you have read, understand, and agree with the following policies and procedures: 

- I authorize East Lake Veterinary Hospital to obtain / release all medical records pertaining to my pet(s) to other facilities as requested by pet's parent (guardian).

- I authorize communication with myself and/or other listed pet guardians via phone, email, text, fax, or other means necessary through the information verified above. 

- I authorize treatment of my pet in an emergency.

- I assume responsibility for injuries or damages caused by my pet.

- East Lake and affiliates to utilize the internet and social media platforms for the free exchange of information, education, marketing, and/or customer service and authorize the use of images of my pet(s) or myself and/or survey responses and/or statements for this purpose. 

- I hearby authorize the veterinary to examine, prescribe for or treat my pet(s). I assume responsibility for all charges incurred in the care of my pet(s), and understand that payment is due in full at the time services are rendered. A deposit may be required in advance of treatment. 

귀하의 신뢰에 감사드리며, 귀하의 애완동물을 돌보기 위해 최선을 다하겠습니다. 저희를 좋아하신다면, 친구들에게 알려주세요. 그렇지 않다면, 저희에게 알려주세요.

bottom of page