New Patient Registration Form

This agreement between Maricamp Animal Hospital (MAH) and our clients is to ensure that all of our patients have the opportunity to live happy, healthy and long lives. It is extremely important for our patients to maintain their annual wellness exams (every year) for adults or semi-annual exams (every 6 months) for senior patients in order to achieve the preventable measures needed for their overall well being. An annual wellness is time you get to spend with the doctor to ask any questions or address any concerns. Most importantly, the examination given by the doctor can reveal informative information about​​your​​pet’s health. The doctor will listen to the heart and lungs, make sure lymph nodes are normal size, talk to you about any lumps/bumps or developing dental disease or arthritis. The more we are able to prevent disease processes, the longer and healthier life your​​pet will live. It is our responsibility to make sure our patients receive the best possible medical care and we believe wellness is the key.

1. I acknowledge, open and honest communication is a must to ensure to the best relationship possible with MAH.
2. I acknowledge, wellness visits are important for the health and well being of my pet.
3. I understand, MAH has a reminder system in order to ensure my pet completes annual or semi-annual wellness visits.
4. MAH reminder system consists of reminder cards, emails and personal phone calls.
5. I understand, MAH will continue to try to contact me on a weekly basis until contact is made and we have develop a plan for the future.
6. I acknowledge, MAH understands that life gets in the way sometimes and it is difficult to answer your phone. However, our priority is to advocate for your pet and their health. Therefore until we reach someone and a plan is in place for the care of your pet, we will continue to try to contact you.
7. It is crucial at this point to be open and honest with MAH to ensure you arecomfortable and happy with the plan that we agree upon.
8. I acknowledge, MAH calls to follow up with our patients after their appointment to ensure the client completely understands the previous appointment, any medications prescribed and the patient is doing well and continuing to improve.
9. I acknowledge, MAH collects emails for internal promotional items only such as monthly promotions, specials and events. This is a good example of continued communication.
10. I acknowledge, MAH will always provide the client with a written estimate for all services and this estimate must be signed at every visit. An estimate is our way of keeping the line of financial communication open.
11. a. It is not expected all items on an estimate is to be completed at the current visit. Items on estimates are a full medical plan of all services your pets is due for and all recommended treatments. We are more than happy to help you with a plan if needed.
12. I understand, MAH will create future plans for all services that were not completed at the current visit following the veterinarians’ recommendation.
13. a. MAH has monthly promotions and specials in order to give all clients an opportunity to financially afford any annual or medical needs and promotions can be found on our Website.
14. I acknowledge, MAH will require by law a current rabies vaccine in order to be seen by a veterinarian.
15. I acknowledge, MAH requires all patients boarding with us must be up to date with annual vaccines including DHPP vaccine, Bordetella vaccine, Rabies Vaccine and a current Negative parasite screening test with in the last 6 months. This is to ensure all borders are protected against highly contagious diseases.
16. I acknowledge, MAH is a medical hospital that schedules appointments in advance. Walk-ins are welcome, however, appointments will be seen first by the veterinarian.
17. I acknowledge, MAH accepts emergency day time visits and a medical emergency will become priority for the veterinarian and staff.
18. I acknowledge, MAH has a 24 hour advance notice appointment cancelation and/or no show fee of $15. This ensures that all of our clients and patients have the same opportunity to be seen for their medical needs. When you cancel last minute or no show to an appointment, you deprive a patient from being able to be seen by the veterinarian.
1. a. MAH will call and email clients 2 days in advance. If you need to change or reschedule your appointment, please do so at this time. No fee will be charged if you reschedule the day of your appointment or cancel before the 24 hour mark.
19. I acknowledge, the Florida Prescription Law requires a current wellness exam within the last year to receive any prescriptions.
20. I acknowledge, MAH has a prescription refill policy that includes medications to be filled will need a Doctors approval. If there are any questions or concerns, we will give you a call. The prescription will be ready for pickup within a 24 hour window once the prescription has been requested and we will give you a courtesy call to let you know that it is ready for pick up.
21. I understand, it is the owners’ responsibility to explain to MAH if you want to change the way you participate in our reminder system or follow up calls. If at any point, the owner declines contact from MAH then it is the owners’ responsibility to keep up with their pets’ wellness plan and medical needs. MAH would then only call one time every 6 months just to touch base with you and check in to see how the pet is doing and see if you have any questions or concerns.

Open and Honest Communication with Education and Mutual Agreements between MAH and our Clients is the Key to Happy and Healthy pets in Marion County! We believe that all pets deserve the right to be treated like a family member.

☺ ​Gentle & compassionate care to ensure a happy and healthy pet!​☺

*I have read the above conditions and policies and I am willing to engage in a relationship with Maricamp Animal Hospital. We look forward to you becoming part of our MAH family and we are blessed you have allowed us to help your four legged family members be around as long as possible!