New Patient Form

Please fill this section in if we are not your primary care veterinary hospital. By listing your primary care veterinarian, you are authorizing Stoney Creek Veterinary Hospital to release patient information to the primary care hospital or veterinarian.

Please review the following policies for Stoney Creek Veterinary Hospital. Our practice firmly believes that a good physician/patient relationship is based upon understanding and good communication. Questions regarding our policies should be directed to our Practice Manager.

Payments: Payment is required at the time of service.
We accept Visa, MasterCard, Discover, American Express and Care Credit.We also accept payment by personal check, cash and Scratchpay.In the event of a non-sufficient fund (NSF) check, there will be an additional $30 NSF charge added to the total balance due.

Outstanding balances: We may require previous balances to be paid in full prior to scheduling an appointment for your pet. If you have an unpaid balance at the end of our monthly billing cycle, we will apply a $3 billing charge and 1.5% finance charge to your account that will continue to accrue each month until the bill is paid in full.
Stoney Creek Veterinary Hospital will send your account to our collection agency for balances not paid within 90 days. In the event that your account is placed for collection, a reasonable collection fee will be added to your account, along with any additional fees, attorney fees and/or court costs that may be necessary for the recovery of the outstanding balance.

I, the undersigned, authorize that I am the owner (or the owner’s authorized agent), of the animal(s) listed above. I hereby authorize Stoney Creek Veterinary Hospital to examine, treat, medicate (including anesthetics or sedatives) and perform diagnostic or surgical procedures as deemed necessary for my pet(s). I understand that I can request an estimate for services. I have read the above payment policy and agree to pay all fees for services rendered, at the time the services are performed, or at the time my pet is discharged from the hospital.

Due to the nature of medicine, and to the limitations inherent to working with veterinary patients (who cannot describe their symptoms and who can be difficult to medicate), I realize that no guarantee of treatment can be made. While every effort will be made to discuss treatments and diagnostic procedures prior to initiating them, if I cannot be contacted in the event of an emergency, then I authorize Stoney Creek Veterinary Hospital to use professional veterinary judgment in the care and treatment of my pet and I agree to pay all accrued charges. I understand that hospital personnel are not present overnight - for this reason, Stoney Creek Veterinary Hospital will recommend transfer to a 24-hour hospital for all patients needing overnight monitoring or treatment.

Thank you for trusting your pet’s health and medical care to Stoney Creek Veterinary Hospital. When you schedule an appointment with Stoney Creek we set aside enough time to provide you with the highest quality care for your pet. Should you need to cancel or reschedule your appointment please contact our office as soon as possible, and prior to 24 hours before your scheduled appointment. This gives another pet (needing an urgent appointment) the ability to get seen by one of our Doctors. ‘No show’ and ‘late cancellation’ appointments delay the delivery of healthcare to other patients, some who are quite ill. A ‘no show’ appointment is missing a scheduled appointment. A ‘late cancellation’ is canceling an appointment with less than 24 hours of the appointment.

Appointment Cancellation/No Show Policy:

Effective October 15th, 2021 any client who ‘No Shows’ or fails to cancel/reschedules an appointment and has not contacted our office with at least 24 hours notice will be considered a ‘No Show’. Upon missing the scheduled appointment, we will alert the client of the missed appointment and of this agreed upon policy.

If a client fails to show or cancels/reschedules an appointment without 24 hour notice a second time the client will again be contacted and reminded of this agreed upon Policy. After this second ‘No Show’ all future appointments will require a non refundable deposit in the amount of our current Office Exam cost. Assuming the appointment is maintained the appointment deposit will be applied to the service invoice as a credit to offset the cost of the Office Exam. If the client does not show or call for the appointment (this being the third ‘No Show’ time) the deposit will not be refunded, and the patient may be dismissed from the practice.
We understand that unforeseen situations, and emergencies occasionally arise and you may not be able to keep your scheduled appointment. If you should experience extenuating circumstances please contact our Office Manager.

You may contact Stoney Creek Veterinary Hospital 24 hours a day, 7 days a week at 610-328-3600. Should it be after regular business hours, you may leave a message. Messages left to reschedule or cancel prior to 24 hours of the appointment are acceptable.