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Welcome to our hospital! We invite you to browse our website to learn more About Us and our practice philosophy. On our website you can meet Our Doctors and Our Health Care Team, learn about our Services, keep updated on important Pet Health News such as pet food recalls and visit our extensive Pet Health Library to learn about pet care topics that are important to you and your pet.

After you make an appointment with our hospital, you can expedite your check in by submitting this form. Please give us 72 hours prior to your scheduled appointment to process this form. If it is less than 72 hours from your scheduled appointment, please call the office to alert us the form has been emailed. To make an appointment please call our office at 203-846-3495. Thank you.

Broad River Animal Hospital New Patient Form

Welcome to Broad River Animal Hospital. We are happy that you have chosen us to care for your valuable pets.

I hereby authorize the doctors and staff to diagnose, prescribe for, and treat the above described pet. I assume all responsibility for all charges incurred in the care of this animal. I also understand that these charges will be paid at the time services are rendered. In the case of hospitalization, I will be required to leave a deposit. The remaining balance must be paid in full at the time of discharge of the pet.

Please present a valid drivers license or photo ID at the time of check-in.

PET INFORMATION:

AUTHORIZED REPRESENTATIVES:

The individuals listed below are authorized representatives to act on your behalf in cases dealing with the pets listed above. They are authorized to obtain medical information regarding your pet, to admit and pick up your pet from our facility, and give verbal and/or written authorization to perform medical services and procedures. The individuals listed below are required to show photo identification when acting as your authorized representative.