New Client

Address *

Line 1

Line 2

City

State

Zip Code

Country

Co-Owner's Cell Phone Number *

Co-Owner's Home Phone Number *

Co-Owner's Work Phone Number *

Birth Date/Age *

Does your pet have any chronic health problems we should know about. *

Have you already set up an appointment with Bijou Animal Hospital? *

Yes No

If no. Do you want us to contact you to set up an appointment? *

Yes, please call. Yes, please email. No, I will submit a request through the website. No

Has this pet been seen at another animal hospital or clinic? If yes, what is the name of the hospital or clinic so we can try to get copies of their medical history. *

Do you have any Medical Records you would like to upload? *

Max file size: 20MB

Would you like to upload a profile picture? *

Max file size: 20MB

If you have additional pets you wish to add to your account here please use the New Pet Form for each additional one.

Financial Policy

All outpatient fees are due at the time the service is preformed. Surgery and hospital fees are payable before the patient is released from the hospital. Bijou Animal Hospital accepts Cash, Checks, Mastercard, VISA, Discover, American Express, Apple Pay, Android Pay and Carecredit*.
* Carecredit No Interest promotional offers are only available on purchases greater than $200.

New Client Form

Financial Policy

Hours