Client Registration and Emergency Authorization

  • Client Registration and Emergency Authorization Form
  • Thank you for choosing Coast Veterinary Services. We are so happy your here!
    We are dedicated to providing your pets and horses with high quality compassionate medicine. We look forward to becoming an important part of keeping them happy and healthy.
  • Tell us about you!
  • Tell us about your pet or horse!
  • Other concerns I have with my pet/horse are:

    Do you have other pets/horses to register with us? Enter their information here
  • My preferred method of commincation:
  • I understand that payament is due in full at the time of service. We will gladly prepare a written treatment plan before services are rendered upon request.
  • In the case of a medical emergency, if I cannot be reached, I herby give the below person(s) permission to authorize Coast Veterinary to provide any medical treatment deemed necessary for my horses or pets and permission for the doctor to treat to their best clinical judgment. I will be responsible for charges incurred in that treatment.
  • Thanks for entrusting us with your four legged friends care. We consider it an honor and strive to provide the highest quality care available.
    Be sure to "like" us on Facebook or follow us on Instagram!