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(336) 275-7266 Appointments

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About Us
Services
Client Information
Online Store

New Client Form

Please note: all new client forms must be submitted prior to scheduling a new client appointment

Owner’s Name*
First Last
Secondary Owner's Name
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Cell Phone*
Work/Other Phone*
Secondary Owner's Phone
Email*
Drivers License/ID*
Emergency Contact Name*
Emergency Contact Phone Number*
How did you hear of us?*
- Drove By
- Facebook
- Google
- Internet Search
- Website
- Other
Pet (Patient) Information
Pet’s Name*
Date of Birth*
Species*
- Dog
- Cat
- Other
Sex*
- Male
- Male - Neutered
- Female
- Female - Spayed
Breed*
Color*
Financial Responsibility and Policies*
- I hereby authorize the veterinarian to examine, prescribe for, or treat the above-described pet(s). By signing this form, I agree I am 18 years or older and I assume full responsibility for all charges incurred in the care of this animal. I also understand that these charges will be paid at the time of release and that a deposit maybe required for surgical treatment.
Financial Policy

Thank you for choosing Southwoods Animal Hospital. Our mission is to partner with our clients, staff, and community to help pets live longer, happier, and healthier lives. An important part of the mission is making the cost of optimal care as easy and manageable for our clients as possible by offering several payment options. Southwoods Animal Hospital requires payment in full at the end of your pet’s examination and/or at the time of discharge. We do not provide in-hospital payment plans.

Payment options include Cash, Check, Visa, Mastercard, Discover, and American Express. If you would like to use a third-party monthly payment merchant, we work with Care Credit and Scratch Pay.

**All services and procedures performed within the hospital are non-refundable**

Outstanding account balances past 30 days will be sent to a collection agency. The client will be financially liable for all fees associated with the collection process including but not limited to attorney fees incurred during collection efforts.

Additional Policy Information

Southwoods Animal Hospital charges $25.00 for returned checks and client accounts are subject to management review for continued services.

Pet Insurance:For clients with pet insurance (non-Trupanion), we are happy to provide you with the necessary documentation to submit a claim to your insurance carrier. If you have Trupanion insurance, please see one of our team members about Express Payment Options.
Social Media Policy*
- I understand that by signing this document, I authorize the staff at Southwoods Animal Hospital to use photos of my pet on their social media, website, and advertising.
- I have read and understand my Client Rights & Responsibilities (linked below)
Southwoods Client Care Agreement.
By signing below, you agree to the foregoing terms of payment and policies.
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Signature*

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Make an appointment
with us today!

Call (336) 275-7266

Contact Southwoods

Our Location
3005 Randleman Road,
Greensboro, NC 27406

336-275-7266
info@southwoodsvet.com
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Business Hours

Mon - Fri: 7:00am - 6:00pm
Saturday & Sunday: Closed

For after-hours emergencies contact:

Happy Tails Veterinary Emergency Clinic - (336) 288-2688
2936 Battleground Ave Greensboro NC 27408
-or-
Carolina Veterinary Animal ER & Trauma Center - (336) 632-0605
501 Nicholas Rd Greensboro NC 27409

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