1215 E Northern Avenue Phoenix, AZ 85020

Phone : 602-944-9661

Fax : 602-997-6647

Pet Records

New Clients

Phoenix Veterinary Hospital Palo Verde - New ClientsWe welcome all new clients to our veterinary facility. We invite you to contact us today. We would love to discuss your pet's care. If you have any questions or concerns, please don't hesitate to call us at 602-944-9661. Please print and bring the completed form below with you on your visit.

If you would like to fax your pet's medical history, you may send all pertinent records to us at 602-997-6647.

Thank you for being part of the Palo Verde Animal Hospital family! We look forward to meeting you and your pets!

New Patient Registration Form - Required - Download & Print Form



  • Patient Information (This visit)

  • Payment Information

    PROFESSIONAL FEES ARE DUE AT THE TIME SERVICES ARE RENDERED. In cases of extensive medical or surgical procedures, when full payment may be difficult at discharge, we accept Visa, Master Card, Discover, American Express or CareCredit. There will be a $30.00 service charge for any check returned unpaid. If you fail to pay any sum due and this matter is placed with a collection agency, or an attorney for collections, you shall be obligated and agree to pay for all costs and expenses incurred (including a collection fee, plus all attorney’s fees, court costs and other expenses through judgment and post-judgment), which shall be payable whether or not an action or proceeding is commenced or prosecuted to judgment. Any balance remaining on the account over 30 days will result in a monthly service charge. A $7.50 minimum or 1.75% service fee of the unpaid balance, whichever is greater, will be added to the outstanding balance. The service fee is not intended to be an interest charge, but reimbursement for servicing the account.
  • Other Pet's Information

    If you have other pets in oyour household, please list them below.
  • Pet's NameDogCatOtherDOB/AgeSexBreedColorSpay/NeuterDates of Vaccinations 
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