• Welcome to Burr Ridge Veterinary Clinic and thank you for giving us the opportunity to care for your pet! Please complete and submit our New Client Information Form before your appointment so we have all the information needed to contact you. Thank you!

  • Download fillable PDF New Client Form here
Owner Information
Type of Phone
Street Address
County
What is your preferred phone number for us to call you?
How did you hear about us?
  • Please provide an emergency contact number which will only be used if we are unable to reach you while your pet is in our care:

I understand that ALL PROFESSIONAL FEES ARE DUE AT THE TIME SERVICES ARE RENDERED. In cases of extensive medical or surgical procedures, when full payment may be difficult at discharge, we take MasterCard, Visa, Discover, American Express, or Care Credit. There will be a $25.00 service charge for any check returned unpaid.

To prevent the spread of infectious diseases, all hospitalized patients must be current on all vaccines. The signature below authorizes this level of preventive care and the appropriate charges will be assessed in the discharge invoice.

Please note your contact information will only be shared with our vendors to notify you about appointments and service reminders, and to communicate important information about BRVC and/or your pet(s).
Pet Information
Species
Second Pet Information
Species
Signature of Responsible Agent for Pet(s)
Sign above