New Client Form

Welcome to Advanced Animal Care in Fort Mohave, AZ! Our team is excited to meet you and your pet and begin the long, rewarding journey of keeping them healthy. Before you make an appointment, please take a minute to read through and fill out our new client form. This form gives us essential information about you and your pet and helps us build a new file for you both.

If you have any questions before getting started, just call (928) 770-4918!

New Client Form

Please note: We are unable to take new clients until July of 2024. If your pet is having an emergency, please call us at (928) 770-4918.

New Client Form

Thank you for your interest in becoming a client of Advanced Animal Care! Due to a high volume of new client requests it may take us up to 7 days to contact you. If your pet has an urgent medical concern that cannot wait, please call (928) 770-4918 as soon as you fill out this form.

I understand that due to a high volume of no show appointments, Advanced Animal Care requires a deposit of $50.00 for new clients on their first scheduled appointment.
I understand that if I am more than ten minutes late, miss, or cancel my first scheduled appointment without 24 hours notice, my deposit is forfeit and I will need to provide a new deposit to schedule future appointments.

We pride ourselves in offering high quality medical care to our patients while focusing on preventative medicine. We look forward to serving you and caring for your pets for years to come. Please fill out all the information on this form for accuracy. You must be 18 years or older to obtain a client relationship with us.

How did you hear about us?
Mailing Address
Mailing Address

Pet Information

Pet Species

Maximum file size: 52.43MB

Medical Authorization and Financial Information

I hereby authorize the doctor and assistants to administer treatment as is considered therapeutically and/or diagnostically necessary. I authorize medical treatment, as well as possible alternate modes of treatment which are explained to me by the medical staff. Patient confidentiality will be maintained. I authorize images of my pet(s) to be used in social media or for educational purposes. I assume financial responsibility for all charges incurred to the patient. I further understand that if I fail to pay the entire amount, I will be responsible for all attorney's and collection costs incurred for the purpose of collection. I hereby certify that I have read and fully understand the above authorization. Balances due over 30 days will be charged a 1.5% per month interest charge (24% APR) and a monthly billing fee of $5.00. Additional collection fees will be charged if your past due account is sent to collections.
We do not accept personal checks. We accept CareCredit and Scratchpay, but do not offer payment plans.

Cancellation Policy for Established Clients

Due to an increase in last minute cancellations and missed appointments, we have instated a new cancellation policy for existing clients. If we do not hear from an established client 10 minutes into their scheduled appointment start time it is considered a missed appointment. We require 24 hour notice for cancellation of an appointment. The first time an established client misses their appointment or cancels without 24 hour notice - It's on us - we all get busy! If an established client has this happen a second time within a 12 month period they will need to prepay for future appointments. This means leaving a deposit of either an examination fee or 50% of their surgical procedure's estimated cost on their account. If a client misses or cancels a prepaid appointment without 24 hour notice their deposit will be forfeit and their deposit will not be refunded. Multiple "no shows" in any 12 month period may result in termination from our practice.
Happy Beagle Laying Down