Open Mon - Fri: 7am - 7pm |
Sat: 7am - 5pm | Sun: 9am - 5pm
 Phone: (949) 612-2756

New Client Form

Welcome! The following information will help us to set up and maintain a file for your pet. Thank you! 

YOUR INFORMATION
RESPONSIBLE PARTY (In Case of an Emergency)
NEAREST RELATIVE not living with you (other than listed above)
OTHER PERSON(S) AUTHORIZED TO PRESENT PETS FOR TREATMENT
PET INFORMATION
PET INFORMATION
I agree that, Newport Harbor Animal Hospital and its employees may take and use photographs of me and/or my pets, with or without my name, only for such purposes as publicity, illustration, advertising, and Web content.

It is our policy to provide you with an estimate of charges for any medical treatment, surgery, or hospitalization that will be provided. A deposit may be required prior to treatment, based upon the amount of the estimate.
Acceptable forms of payment are: Cash, Visa, MasterCard, American Express, Discover, and CareCredit.

*ALL CHARGES ARE DUE AND PAYABLE UPON PATIENT’S RELEASE*