550 NE 44th Street
Fort Lauderdale, FL 33334
Open Monday - Friday: 8:00AM - 6:00PM,
Saturday: 8:00AM - 3:00PM,
Sunday: CLOSED
Email Us
Call Us: (954) 280-5460
Emergency Information
CareCredit
 

New Patient Form


Thank you for visiting our hospital. We look forward to getting to know you and your pet. Please help us to provide the best care possible for your pet by taking a moment to fill out this form.

Client / Owner Information
Any pictures taken will not be used for advertising purposes, will only be used for fun pictures on our website.
Spouse / Co-Owner Information
How did you hear about us?
Doctor Referral
If you have been referred to us by another veterinarian, please provide their information below.
Please tell us about your pet(s)
Please tell us about your pet(s)
Please tell us about your pet(s)
Agreement
  • Professional fees are to be paid at the time services are rendered.
  • Park Veterinary Hospital is not in the business of advancing credit to its customer. All accounts will be billed monthly and all outstanding balances are due and payable when rendered. Any account which is not paid in full will be assessed a service charge of $7.50 or 1.5% of the unpaid balance, whichever is greater. If payment cannot be made in full Park Veterinary Hospital reserves the right to withhold your pet until payment is met at an additional charge of the nightly boarding rate.
  • THERE IS A $350.00 SERVICE FEE FOR ANY ACCOUNT THAT MUST BE TURNED OVER TO OUR COLLECTION DEPARTMENT. In the event that suit is filed, venue will be Broward County, Florida.
  • Furthermore, I agree that I will be held personally responsible for all costs associated with the collection of this account, including but not limited to: a collection agency fee and court costs.
  • I also understand that all returned checks will be assessed a $35.00 service charge.