Client/Patient Information Form

Welcome to VCPI! We look forward to meeting you and your pets!

APPOINTMENT
7

Client/Patient Information Form

In an effort to enhance your experience with our clinic, we offer our Client/Patient Information Form online so you can complete it in the convenience of your own home or office. This will help make your visit with us go smoother and helps us treat patients as efficiently as possible.

MM slash DD slash YYYY
Name(Required)
Address(Required)

Pet Information

Sex(Required)

AUTHORIZATION

I affirm that I am the owner of the above animal or am responsible for it, am 18 years of age or older, and have the authority to execute this consent and hereby authorize Veterinary Center of Parker, Inc. after consultation with me to administer treatments and perform procedures that are necessary for the well-being and care of the Pet.  I understand that there are no guarantees associated with any treatments and procedures. 

I assume personal financial responsibility and agree to pay for all charges and expenses invoiced at the time of service. I agree to pay a recurring 1.5% per month interest on any amounts unpaid after 30 days, a $40 service charge for each NSF check, and any and all costs and expenses, including legal fees, for the collection of any and all unpaid amounts.
 If I neglect to pick up the pet within five days of written notice, sent to the above address, my pet will be considered abandoned. In cases of abandonment, Veterinary Center of Parker, Inc. will have authorization to take care of the pet as seen fit. Abandonment does not release me from my obligation to pay for all charges involved.(Required)

RECORDS RELEASE

I hereby give Veterinary Center of Parker, Inc. its representatives, and employees permission to send my pet's records as needed to other clinics and facilities.
(Required)

MEDIA RELEASE

I hereby give Veterinary Center of Parker, Inc. its representatives, and employees the right to take photographs and videos of me and/or my pet, and to copyright, use, and publish the same in print and/or electronically. I agree that Veterinary Center of Parker, Inc. may use such photographs/videos of me and/or my pet with or without my pet's name and for any lawful purpose, including, for example, such purposes as publicity, illustration, advertising, social media, and Web content. I understand my pet's image may be edited, copied, exhibited, published, or distributed, and waive any right to royalties or other compensation arising or related to the use of my pet's image or recording.
(Required)

PRESCRIPTION AND SUPPLEMENT RETURN POLICY

Federal regulations prohibit the return of any prescription product that has been filled and left our premises. This also includes our supplements and preventatives.(Required)

CANCELLATION, NO SHOW AND LATE FEE POLICY


Each time a patient misses an appointment without providing proper notice, another patient is prevented from receiving care.

If an appointment is missed without 24 hours notice, we reserve the right to charge a no-show fee of up to $75 and ask that you pre-pay the exam fee for future appointments.

If you miss three or more appointments, we reserve the right to proceed with termination from the practice.

If you arrive more than 10 minutes late for your scheduled appointment, we will discuss with our technical staff if we are able to still work you in as we will then be behind in our schedule. If we can work you in, there will be a $15 work-in fee assessed.

If your pet is scheduled for a procedure with a specialist, we require a $300 deposit due at the time of scheduling the procedure. This deposit will be credited at the time of appointment.

If you are needing to cancel your specialist appointment, we require a 48-hour notice or your $300 deposit will be retained for a specialist cancellation fee. 

Each time a patient misses an appointment without providing proper notice, another patient is prevented from receiving care. If an appointment is missed without 24 hours notice, we reserve the right to charge a no-show fee of up to $75 and ask that you pre-pay the exam fee for future appointments. If you miss three or more appointments, we reserve the right to proceed with termination from the practice. If you arrive more than 10 minutes late for your scheduled appointment, we will discuss with our technical staff if we are able to still work you in as we will then be behind in our schedule. If we can work you in, there will be a $15 work-in fee assessed. If your pet is scheduled for a procedure with a specialist, we require a $300 deposit due at the time of scheduling the procedure. This deposit will be credited at the time of appointment. If you are needing to cancel your specialist appointment, we require a 48-hour notice or your $300 deposit will be retained for a specialist cancellation fee.(Required)

STAFF AND CLIENT EXPECTATIONS

We want to make sure you know what you can expect from VCPI in terms of our staff providing care to you and your pets. We also want to outline what we ask from you as clients here at VCPI.

What you can expect from VCPI:
  • Helpful, educational, and engaged staff.
  • Clearly communicated timelines, recommendations, and expectations.
  • Top-notch care for your pets.
  • To be treated with respect and care.

What we ask from you as a client:

  • We are always happy to provide information and education and ask that if there is anything you do not understand that you ask us first.
  • If you do not receive 5-star care, we ask that you contact us directly first so we can have the chance to improve.
  • We expect you to treat our staff with respect and care. We have a no-tolerance policy for bullying and/or harassment.
We want to make sure you know what you can expect from VCPI in terms of our staff providing care to you and your pets. We also want to outline what we ask from you as clients here at VCPI. What you can expect from VCPI: -Helpful, educational, and engaged staff. -Clearly communicated timelines, recommendations, and expectations. -Top-notch care for your pets. -To be treated with respect and care. What we ask from you as a client: - We are always happy to provide information and education and ask that if there is anything you do not understand that you ask us first. -If you do not receive 5-star care, we ask that you contact us directly first so we can have the chance to improve. -We expect you to treat our staff with respect and care. We have a no-tolerance policy for bullying and/or harassment.(Required)

You can schedule/change an appointment from our App, your Pet Portal or call to speak with a Client Care Representative at 720.851.0820.

Thank you for your understanding and cooperation as we strive to best serve the needs of all of our patients.

Visit Our Client Resource Center

Visit out our client resource center to browse helpful resources such as videos on various pet topics, tips on puppy and kitten care, and brochures on some of the products and services we offer.

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Connect For Care

Connect for Care (previously called Return for Care) is a unique CVMA member benefit program designed to unify veterinarians, shelters, and pet owners all around the same common goal: ensuring adopted shelter pets receive the lifelong health care they deserve.

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Contact Us

We're proud to serve Parker, CO and the surrounding communities.

There is no question too big or too small. If you need anything at all for your pet, please use the information below to contact us immediately.

Location

12311 Pine Bluffs Way, Unit 115
Parker, CO 80134

Hours

Mon – Fri: 7:30AM – 5:00PM
Sat: 8AM – 12PM, Sun: Closed
*Closed 11 AM - 1 PM on Wednesdays for a staff meeting

Contact Info

P: 720-851-0820
E: info@vcparker.net

We're proud to be AAHA accredited.

We are an AAHA-accredited veterinary hospital. That means we hold ourselves to a higher standard. Pets are our passion, and keeping them healthy is our number one priority. We strive to deliver excellent care for pets because your pets deserve nothing less.

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Have a question?

Complete the form below, and we'll be in touch with you shortly. If you need immediate assistance during business hours, please call us directly at 720-851-0820.

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We look forward to seeing you and your four-legged family members soon!