New Customer

If you have decided to join the Deerfield Family, please complete this simple form.
As a token of our appreciation, we will take $15.00 off your first visit.
Thank you for your interest in Deerfield Veterinary Hospital.

New Client Form

Client Information
Address
Contact Information
First Pet's Information
Second Pet's Information
Third Pet's Information
Hospital Authorization
I authorize the staff of Deerfield Veterinary Hospital PC to diagnosis, treat, care and prescribe for the above named animal(s), under the direct supervision of a liscensed veterinarian. I also understand that payment is due when services are rendered.
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