New Client Form


We understand that your pet’s health is a top priority and appreciate your trust in our ability to care for them.

To ensure that we can provide the best possible care, please take a few moments to fully complete this form.

Thank you for your cooperation, and we look forward to assisting you and your furry friend.



"*" indicates required fields

Pet Owner Information

"*" indicates required fields
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Marketing Release Information

We want your pet to be Facebook famous, but we need your permission first.

I grant permission to Caldwell Animal Health Inc. dba Culbreth Carr Watson Animal Clinic (CCW), its employees and authorized representatives to take photographs and/or video of me and/or my pet(s), to copyright, use and publish the same in print and/or electronically. CCW may also use and publish my pet’s story, including relevant medical history.

I agree that CCW may use such photographs, videos or stories including me and/or my pet with or without our names and for any lawful purpose, including for example such purposes as social media, publicity, advertising, and other Web content.
Owner Signature*

Patient Information


Please read and sign the following authorization for treatment:

I am 19 years of age or older, and I hereby authorize the staff of Culbreth Carr Watson Animal Clinic to render any treatment which is deemed necessary while in custody of the clinic.

I understand that in the event of any unusual or emergency circumstances, the staff will make every attempt to contact me, or my designated representative, before proceeding with treatment.

I understand that I will be financially responsible for all procedures and costs, including any estimate of charges for treatment provided to me in person or over the telephone. Payment is due at the time services are rendered. A $30.00 returned check fee will be charged for all returned checks. I understand that if at any time there is an unpaid balance on my account, there will be an additional 33.33% collection agency fee and my account will be placed with a collection agency, which will appear on my credit report, and that I will be held responsible for attorney fees and court costs if such be necessary.

I give Culbreth Carr Watson Animal Clinic and/or our agents, to contact you by telephone at any phone number associated with your account, including wireless phone numbers, which may result in charges to you. Methods of contact may include use of auto dialing equipment and/or pre-recorded artificial voice messaging, text messaging or email.
Owner Signature*
This field is for validation purposes and should be left unchanged.