Online Registration Form

Please check each box to show you have read and understand the following:

By submitting this form, I certify that I am the owner or authorized agent for the animal described above. I consent to have the veterinarian and staff of NVRH examine and treat my pet. I certify that all of the information I have provided above is true to the best of my knowledge. I am over 18 years of age. I have been given the opportunity to review and ask questions which I may have about the material above. I consent to have copies of my pet's medical record faxed to my referring veterinarian.

It is the nature of emergency medicine that situations which cannot be predicted and which require emergency treatment, may arise. In those situations, treatment often must be initiated immediately and without the veterinarian having time to contact the owner. Because of this, we require all owners to state their wishes with regard to CPR and other emergency life-saving procedures before leaving their animals. Please be aware that the cost for basic CPR can range from $300 - $500.