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New Client Form

Thank you for choosing Prairie View Animal Hospital for your pet’s care. Our New Client Form helps us gather the information we need before your first visit so we can provide a smooth, efficient experience for you and your pet.

If you are a new client visiting our veterinary hospital in DeKalb, IL, please complete this form before your appointment whenever possible.

Happy dog isolated on a gray background

What to Expect Next

Once your form is submitted, our team will review the information as part of preparing for your pet’s appointment. If we need any additional details before your visit, we will contact you.

(By providing your email address, you will automatically be signed up for our pet portal, where you can view all your pet’s medical records online. If you choose not to sign up, please let the receptionist know in advance.)

Patient Information

(We will not use your name or any personal information.)

Medical History

Credit & Collection Policy

  1. All charges are expected to be paid in full at the time of service, and for new clients.
  2. A finance charge of 18% APR is applied to any balance that is over 30 days old. Monthly payments are required, and any accounts greater than 90 days without a payment are subject to referral to our collection agency and will be charged a collection fee of 33% of the balance and a $10.00 fee if a certified letter is sent.
  3. A $20.00 no-show fee will be charged to the account for every missed appointment.
  4. A $25.00 fee will be applied to all returned checks.
Clear Signature
Clear Signature

Thank you for choosing Prairie View Animal Hospital to care for your pet(s). We will be happy to answer any questions you have about your pet’s health. To ensure the best possible care, please make sure all the above information is complete and accurate. Thank you!

A gray cat being pet by a veterinarian

Need Help?

If you have questions while filling out the form or need assistance before your appointment, please call Prairie View Animal Hospital at (815) 756-9976.

If your pet is sick, injured, or needs urgent attention, please call our office directly rather than using this form.

Complete Your New Client Form

Please submit your New Client Form before your visit to help us make your first appointment as easy and welcoming as possible. We look forward to meeting you and your pet.