New Client Form

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Please complete this form before your visit.

Name *

First

Last

Date of Birth *

Primary Phone *

Secondary Phone

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Co-Owner's Name *

First

Last

Co-Owner's Phone

Co-Owner's Email

Pet's Name *

Species *

Dog
Cat

Breed *

Color *

Age/Date of Birth *

Sex *

Male
Male (neutered)
Female
Female (spayed)

Add another pet? *

Yes
No

Payment Policy

Full payment is expected when services are rendered.

Our practice is committed to providing the best treatment to our patients. Our prices are representative of the usual and customary charges for our area. We do not permit billing agreements. We will gladly prepare a written estimate if you desire, please just ask us! We accept all major credit cards, cash, and check. There will be a service charge for any check returned unpaid. Please be aware that if a balance remains unpaid, we may refer your account to a collection agency and you and your family members may be discharged from this practice. To prevent the spread of infectious diseases, all hospitalized patients must be current on all vaccines and free from internal and external parasites. The signature below authorizes this level of preventative care and the appropriate charges will be assessed in the discharge invoice. Thank you for understanding our payment policy. By signing below, I certify that I am 18 years of age or older and that I have read, fully understand and agree to the terms of this agreement, and I sign it voluntarily with full knowledge of its significance.

Signature of responsible party *

Date *

Welcome to Austin Bluffs Animal Clinic

We’re open six days a week to make sure the pets of Colorado Springs get the care that they need.

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Address

4323 Austin Bluffs Parkway
Colorado Springs, CO 80918
Click here for directions.

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Contact Info

Phone: 719-598-7879
Fax: 719-598-7539
Email: austinbluffsanimalclinic@msn.com

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Hours

Mon – Fri: 8:00am – 5:00pm
Saturday: 8:00am – 12:00pm
Sunday: Closed

Have a question?

The team at Austin Bluffs Animal Clinic is here to help! Please complete the form below and a member of our team will get back to you as quickly as possible. If you need immediate assistance, please call us directly at 719-598-7879.