New Client Form

Thank you for giving us the opportunity to care for your pet! Please help us meet your needs better by taking a moment to complete this form.
For quality and training purposes all phone calls are recorded.
I authorize the doctor to provide vaccines and parasite control as needed for my pet. I assume responsibility for all charges incurred in the care of this (these) animal(s). I also understand that these charges will be paid at the time of release unless prior arrangements have been made. A deposit may be required for inpatient procedures at the discretion of the Animal Hospital of Lake Villa. I agree to pay all outstanding balances together with any other charges (finance and/or collection) due thereon. I understand that personal checks are not accepted as a form of payment and I will provide payment in the form of Cash, Care Credit, Scratchpay, Visa, Mastercard, American Express, Discover, or debit cards.

Animal Hospital of Lake Villa
101 S. Milwaukee Ave.
Lake Villa, IL 60046

Phone: (847) 356-8387
Text: (847) 356-8387
Fax: (847) 558-2606

Premier Veterinary Group
Emergency: (847) 548-5300

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