A full-service veterinary hospital
serving Poulsbo's pets since 1952.

Craig Adams, DVM, MS
Bethany Adams, DVM
(360) 779-4640

Poulsbo Animal Clinic
19494 7th Ave, Ste 100
Poulsbo Village Shopping Center
Poulsbo, WA 98370
(360)779-4640
(360)779-2675 fax

American Animal Hospital
Association

Form - Appointment Scheduling

Name (required)
First Name (required)	Last Name (required)

Selection (required)
Current Client
New Client

Pet's Name (required)

Type of Pet (required)
Dog
Cat

What day works best for you?
ASAP
Mon
Tue
Wed
Thurs
Fri
No Preference

Am or PM?
AM
PM
Either

Please list an email address or phone number where we can contact you, whichever is your preference. (required)

Reasons or conditions that prompted your visit? (required)

Special requests or conditions?

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 Poulsbo Animal Clinic 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 will be forwarded to Poulsbo Animal Clinic'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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A full-service veterinary hospital serving Poulsbo's pets since 1952.

Craig Adams, DVM, MS Bethany Adams, DVM (360) 779-4640

Form - Appointment Scheduling

A full-service veterinary hospital
serving Poulsbo's pets since 1952.

Craig Adams, DVM, MS
Bethany Adams, DVM
(360) 779-4640