New Client Registration Form

Please Note

Due to the high volume of new patient requests, please allow 3-5 business days for your registration form and pet’s medical history to be reviewed before we can schedule a visit. New client wellness visits currently have a wait time of approximately 1-2 months.

For hospice and peaceful passing visits: please call (910) 302-6462 to leave a voice message to request these services.

Submission of this form indicates that you agree to the Practice Policies outlined below and agree that payment is due in full at the time of services. Please note that we are unable to accept CareCredit as a form of payment. There is a 3% processing fee for all cards and E-payments.

Thank you and we look forward to meeting you and your pets!

Practice Policies

Please read the following policies prior to submitting the registration form.  Submission of the registration form indicates your acceptance of these policies:

Policies

1. A copy of your pet’s previous medical history is required prior to the first visit.  You can email the records directly, or have your veterinarian forward a copy to likehomevet@gmail.com. If records are not received within 48 hours prior to your home visit, your appointment will be rescheduled or cancelled. There is a $75 cancellation fee.

2. An up-to-date rabies vaccination is required for all pets over 4 months of age to be examined. If your pet does not have proof of a valid rabies vaccination (a signed rabies certificate or signed medical records), then one will be administered during the appointment. This is in accordance with North Carolina law- see below:

RABIES VACCINATION REQUIRED: Pursuant to G.S. 130A-185, every owner of a domestic dog, cat or ferret in North Carolina is required to have their animal currently vaccinated against rabies by four months of age and maintain the animal’s current rabies vaccination status throughout the animal’s entire lifetime. The owner should retain the original copy of the rabies vaccination certificate, provided by the legally authorized vaccinator as evidence of the animal’s current vaccination status. There are no legal waivers or exemptions, rabies vaccinations are required by law for domestic dogs, cats and ferrets in North Carolina.

3. If you need to cancel an appointment, please provide at least 48 hours advance notice. Failure to do so will result in a cancellation fee of $75. If we have already left for that day’s house calls, or if we arrive and the owner (or designated representative) is not available to allow us entry to provide services, the no-show fee will include the travel fee as well as the cancellation fee.

4. Payment is due at the time services are rendered. An estimate can be provided prior to all services, other than the current house call travel fee and examination fee. At this time, cash, checks (from returning clients) and credit cards (Visa, Mastercard, Discover & American Express) are accepted with a 3% processing fee. We also accept E-payments (PayPal and Venmo) with a 3% processing fee. Please note that CareCredit is NOT accepted.

5. There is a $25 fee for returned (NSF) checks, and a $15 per month statement and accounting fee charged on the 1st of each month after the visit for all accounts with outstanding balances. In the event of an account being sent to collection, all reasonable collection fees, attorney fees and court costs will be paid by the client.

6. No Place Like Home Mobile Pet Vet, PLLC does not have the capabilities to perform emergency services, x-rays, ultrasounds or surgery, and is not available for 24-hour emergency care. An emergency/referral clinic is provided below. Please note that emails, calls and texts will not be answered after clinic hours or during holiday/vacation closures. Current clinic hours are Monday through Thursday from 9am-5pm. Check our website or our social media/Facebook page for updated holiday/vacation closures.

For non-emergency services, you are welcome to work with any veterinarian with whom you have a prior relationship, or one can be recommended. The veterinarian you see may make recommendations based on their testing, but if your pet is referred for one of these services the results will also be reviewed by No Place Like Home and a plan will be discussed for your pet’s ongoing health care needs.

Emergency Hospital:

Animal Emergency and Trauma Hospital/Eastern Carolina Veterinary Referral
50 Greenville Avenue
Wilmington, NC 28403
(910) 791-7387 or (910) 790-1070
www.ecvetreferral.com

7. We ask if you could be ready at least 30 minutes prior to your scheduled appointment time, as we may run ahead of schedule some days. If you are not ready at your scheduled appointment time, you will be rescheduled and charged the call out fee.

  • If we have an appointment with your feline family members, please put them in a bathroom or somewhere that we do not have to hunt, chase or pull out from under furniture, to keep our visit as fear free as possible.
  • If your pet requires pre-medications for anxiety, please be sure to give as directed by your veterinarian to eliminate any additional stress. Please let us know if your pet requires a refill prior to your appointment time. A call out fee will be charged to your account, whether your pet is able to be examined or not.

8. No Place Like Home Mobile Pet Vet, PLLC will not tolerate rude, derogatory, belligerent, threatening or otherwise discourteous behavior. We expect all clients and family members to be respectful and courteous at all times. We will refuse to provide services to any client acting in a discourteous manner, and payment for all services performed up to that point will be due in full. At the conclusion of the visit, you will be provided with a copy of your pet’s medical records to facilitate transfer of care to a new veterinarian.

9. Copies of medical records are available via email at no charge. If a hard copy is required, a $10 record fee may be charged to cover the cost of printing, copying and mailing the records.

Owner Information

Name(Required)
Address(Required)

Patient Information

Pet Medical History

Please include all vaccination certificates, exam notes, and lab results​.
Max. file size: 5 GB.
Max. file size: 5 GB.
Max. file size: 5 GB.
Have more files you need to submit? Please email them to likehomevet@gmail.com. You can email the records directly, or have your veterinarian forward a copy.

Acknowledgement