NEW TO WMVC?

Save time by submitting your new client information before your scheduled appointment.

Please ensure you have scheduled your appointment with our front desk team before filling out your new client details below. If you need to discuss an urgent matter or your pet has an emergency, please contact us directly at (707)263-5380.

Client Information

Please fill out all required fields below (*)

Owner

First Name

Last Name

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone

(###)

###

####

Work Phone

(###)

###

####

Cell Phone

(###)

###

####

Would you like to sign up for text notifications in regards to your pet's appointment status and updates with the cell phone number you provided?

Social Security Number

Driver License #

Patient Information

Please fill out all required fields below (*)

Patients Name

Species

Dog

Cat

Other

If other, please specify

Breed

Color

Birth Date

Sex

Male

Female

Neutered or Spayed

Yes

Unsure

Referring or Regular Vet

Appointment Information

If you have already completed an appointment with our team, please share the date and time in the details below

Date

YYYY

Time

Hour

Minute

Second

ACKNOWLEDGEMENT

By checking the box below, you are acknowledging all details from this online submission form is accurate and honest. This includes agreeing to the Important Reminders on the Day of your Appointment section at the top of this page.

Agree

IMPORTANT REMINDERS ON THE DAY OF YOUR APPOINTMENT.

On the day of your appointment, please come with a photo ID (driver’s license preferred) and a copy of your pet’s vaccine or clinical records if applicable.

Please realize we have a cash, check or credit card only policy. We expect payment upon receipt of services rendered and we are unable to set up any charge accounts. We appreciate your cooperation in this matter.

If your account becomes delinquent, we reserve the right to charge a percentage interest amount per month in late charges and you will become responsible for any collection costs, which may be fifty percent (50%) of the unpaid principle balance, as well as court costs and/or attorney fees when so ordered by the court.

We charge $25.00 per returned check, plus bank fees. We may also pursue in court for up to 3 times the amount of the check, plus cost and/or attorney fees when so ordered by the court.