Name: Animal Medical Center of Lapeer
Address: 490 Oak St., Lapeer, MI, 48446, United States
Telephone: 810-664-6524
Price range: $

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Client & Pet Update Form

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Client & Pet Update Form

Animal Medical Center of Lapeer

Welcome back to our clinic and thank you for choosing Animal Medical Center of Lapeer for your pet’s care! Please complete the following information about you and your pet(s) accurately so we may update our records. Thank you!

About You

Name *

First

Last

Spouse/Co-Owner's Name

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Primary Phone *

Secondary Phone

Spouse/Co-Owner's Phone

Owner's Birthday *

Drivers License *

Preferred Method of Contact *

Primary Phone
Secondary Phone
Email

Preferred Method of Contact for reminders *

Call
Email
Text
Mail

About Your Pet(s)

Pet's Name *

Species *

Dog
Cat
Other

If other, please specify *

Breed *

Color *

Sex *

Male
Male (neutered)
Female
Female (spayed)

Age/Date of Birth *

Add another pet? *

Pet's Name *

Species *

Dog
Cat
Other

If other, please specify *

Breed *

Color *

Sex *

Male
Male (neutered)
Female
Female (spayed)

Age/Date of Birth *

Add another pet? *

Pet's Name *

Species *

Dog
Cat
Other

If other, please specify *

Breed *

Color *

Sex *

Male
Male (neutered)
Female
Female (spayed)

Age/Date of Birth *

Have your pets been seen by another clinic since their last visit with us? *

Clinic's Name *

Clinic's Phone *

Reason for Visit *

Cancelled Appointments & No Show Policy

I understand that there will be a $50.00 Fee for Appointments Not Cancelled within 24 hours and No-Show Appointments, also there is a $75.00 Fee for Missed Surgery Appointments. *

I have read and understand

Payment Policy

Our office does not bill. Payment is due on the day of service. We will gladly prepare a written estimate if you desire. Please ask our doctor during your appointment. Occasionally, a deposit may be required for certain procedures. We accept the following forms of payment: cash, credit/debit (including CareCredit, Visa, Mastercard, Discover, and American Express. *

I have read and understand

Treatment/Payment Authorization

I understand every effort will be made to achieve a successful outcome, and provisions will be made for safe in-hospital care and handling. I certify that I am 18 years of age or older and assume responsibility for all charges incurred. I understand that charges are due at the time services are completed unless prior arrangements have been made. I agree that should my account become delinquent; I will be responsible for all collection costs, including but not limited to the outstanding balance, interest, attorney fees, court costs, and collection agency fees. *

I have read and understand

I hereby authorize Animal Medical Center of Lapeer to treat my pet(s) and furthermore understand that unforeseeable adverse reactions to treatments are always possible and authorize treatment necessary should any reactions occur. *

Clear Signature

Please sign

Date *

Social Media Release

I grant permission for Animal Medical Center of Lapeer to use photos of my pet for the purpose of social media posting (Facebook, Twitter, Youtube, and other sites). *

Use image only
Use image and my pet's first name
I do not grant permission

Signature *

Clear Signature

Date *

We’re Excited to Meet you

Veterinary services delivered with courtesy and respect.

Make an Appointment

Questions?

Contact Us

Name *

First

Last

Email *

Phone

How can we help you? *

Message

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Location

490 Oak St
Lapeer, Michigan 48446

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Contact Information

Phone: 810-664-6524
Text: 810-442-0442
Fax: 810-664-6574
Email: [email protected]

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Hours

Monday-Wednesday: 9 AM – 5 PM
Thursday: 9 AM – 5:30 PM
Friday: Closed
Saturday: Closed
Sunday: Closed

COVID-19

Hospital Updates

Our lobby is now OPEN! If you have any additional questions, please give us a call at 810-664-6524.