Name: The Falls Animal Clinic
Address: 15301 S Dixie Hwy, Palmetto, FL33157
Telephone: +1-(786) 592-1483
Price range: $$

First Pet
Select One:*
- Dog
- Cat
Pet Information
Name Breed Microchip# Date of Birth Color Sex Spayed or Neutered
Date of Vaccinations
Rabies DA2P Parvo Corona Bordatella
Date of Vaccinations
Rabies FELV ENT-FVRCP FIP
Second Pet
Select One:
- Dog
- Cat
Pet Information
Name Breed Microchip# Date of Birth Color Sex Spayed or Neutered
Date of Vaccinations
Rabies DA2P Parvo Corona Bordatella
Date of Vaccinations
Rabies FELV ENT-FVRCP FIP
Third Pet
Select One:
- Dog
- Cat
Pet Information
Name Breed Microchip# Date of Birth Color Sex Spayed or Neutered
Date of Vaccinations
Rabies DA2P Parvo Corona Bordatella
Date of Vaccinations
Rabies FELV ENT-FVRCP FIP

PAYMENT IN FULL is required at the time services are rendered. We do not offer any form of billing. We accept cash, VISA, Mastercard, Discover and American Express as forms of payment. We no longer accept checks. Advanced minimum deposit of half of your estimate is expected from you for all after-hour calls and for animals left in the clinic for overnight treatment or diagnostics. This also applies to extensive treatment of severely ill patients or boarders staying longer than one week unless prior arrangements have been made.
- We may take pictures and/or video of your pet as part of their appointment. Please initial if you agree with photos and videos of your pet being shared on our social media platforms, website and Google Business page.
- Please initial if you agree with your pets medical record being shared with a third party company such as the following: New Veterinary Clinics, Emergency Hospitals, Specialist Offices, Insurance Companies, Pharmacies etc
All information I have provided here is true to the best of my knowledge.
I have read and understand the Terms of Service.
Type Signature
Phone
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New Client Form

First Pet

Rabies	DA2P	Parvo	Corona	Bordatella

Rabies	FELV	ENT-FVRCP	FIP

Rabies	DA2P	Parvo	Corona	Bordatella

Rabies	FELV	ENT-FVRCP	FIP