OVMC Website - Oakley, California

Oakley Veterinary Medical Center

4526 Main St.
Oakley, California 94561

(925)625-3722

oakleyveterinary.com

New Client Check In

If you would like to make an appointment, you can assist us to expedite your check in by submitting this form.

Thank you for your cooperation in letting us assist you.

New Client

Name *(required)*

First Name (required)	Last Name (required)

Birthday :

Address (required)
Street Address (required)

City (required) ,	State / Province (required)	Zip / Postal Code (required)

Best Contact Number (required)
Phone Type	Phone Number (required)

E-Mail Address :

Pet's Name(s) (required)

Age(s): Years, Months

Type of Pet (required) :

Type of Pet (Pet 2) :

Breed(s):

Sex: (required)
Male
Female

Sex (Pet 2):
Male
Female

Neutered/Spayed
Neutered
Spayed

Neutered/Spayed (Pet 2)
Neutered
Spayed

Are your pet's vaccines current?
Yes
No

Do you have pet's medical records?
Yes
No

Medical records at another veterinary Practice?
Yes
No

Name of Former Veterinary Practice

May we request a transfer of records?
Yes
No

Would you like us to call you for your appointment

Reasons or conditions that prompted your visit?

Special requests or conditions?

Please list any additional pets here

Please Read
I understand, by indicating I agree and submitting this registration, that I am responsible for any charges incurred by my pet while in the care of the doctors at Oakley Veterinary Medical Center and that charges are due and payable at the time of service, unless other arrangements are made in advance. Any balance that is carried over a period of 30 days will accrue a monthly finance charge of 1.5% or 18% per annum. Any balance that I leave unpaid may be forwarded to Oakley Veterinary Medical Center's collection agency, and will incur a 25% collection fee for which I am liable, in addition to monthly finance charges.

I have read this statement and -
I Agree
I Disagree

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HOURS

Day	Open	Close
Monday	8:00am	6:00pm
Tuesday	8:00am	6:00pm
Wednesday	8:00am	6:00pm
Thursday	8:00am	6:00pm
Friday	8:00am	6:00pm
Saturday	8:30am	3:00pm
Sunday	Closed	Closed

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