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5215 Perkins Road
Baton Rouge, Louisiana 70808

Phone: (225) 766-0550

Fax: (225) 766-0551

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New Client Form

  • NameHis/Her Phone 
  • Cell phoneSpouse's cell 
  • EmployerWork phone 
  • Pet's Information

  • ColorBreed 
  • DateGiven where 
  • Yes (list)No 
    • I am the owner of the animal named above, and I agree to hold Perkins Road veterinary Hospital and its personnel harmless for any disease contracted by said animal during its stay that could have been prevented by a proper preventative medication program. I realize that vaccinations given upon admission to the hospital will not have enough time to fully protect the animal on that particular visit.
    • I realize that pets are only discharged during regular office hours and that any pet left in excess of ten days of the stated discharge date will be considered abandoned.
    • I also realize that FULL payment is due UPON RELEASE OR END OF SERVICE. Applications to defer payment MUST BE made in ADVANCE and all unpaid balances will be subject to a finance charge of 1.5% per month (DM year), with a minimum monthly processing fee of $3.00 per month.
  • SignedDate