Owner Information

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Primary Contact Number *

Primary Contact Type

Cell
Home
Work

Alternate Contact Number

Alternate Contact Type

Cell
Home
Work

Email *

How did you hear of us

I was referred by *

From whom may we obtain previous medical records? (Contact Info) *

Are you interested in learning more about our Prevention Plus Club?

Yes - Ask us at your first appointment or click the link below!
No

Our Prevention Plus Club gives your pet access to doctor-recommended wellness services at an affordable monthly cost. From core vaccinations to an array of preventive care services, our wellness plans deliver personalized care. This care keeps your furry sidekick in the best of health — so the two of you can enjoy more fun together.Prevention Plus Club gives your pet access to doctor-recommended wellness services at an affordable monthly cost. From core vaccinations to an array of preventive care services, our wellness plans deliver personalized care. This care keeps your furry sidekick in the best of health — so the two of you can enjoy more fun together.

Patient Information

Pet's Name *

Sex *

Male
Neutered Male
Female
Spayed Female

Age/Date of Birth *

Breed

Color

Any History of Aggression? *

Yes
No

If yes, please list

Do you have a second pet? *

Yes
No

Pet's Name *

Sex *

Male
Neutered Male
Female
Spayed Female

Age/Date of Birth *

Breed

Color *

Any History of Aggression? *

Yes
No

If yes, Please list

Are there any other pets in the home? Please list their information here:

I permit Hill & Harbour Veterinary Center to post pictures of our experience on social media such as Twitter, Facebook and Instagram. Confidential information will never be shared with anyone. *

Yes
No

Download our free app to view your pet's medical reminders, request appointments or medication and food refills, track your rewards points, and so much more!

Owner Name *

Vaccine Questionnaire

Please check the box that most describes your pet’s lifestyle so that we can discuss the proper vaccines for your pet at his or her first appointment.Please review the next page for current vaccination guidelines from the American Animal Hospital Association and let us know if you have any questions or concerns regarding the information at your pet’s next visit.

Bordetella and Canine Influenza (canine only):

Does or will your pet go to the groomer, dog park, day care, group training classes, or boarding facilities?

Yes
No

Lyme (Canine Only):

Do you ever see ticks on yourself or on your dog?

Yes
No

Does your dog spend time around shrubs, bushes or tall grass?

Yes
No

Does your dog spend time in places where wildlife have access (Ex: Deer)

Yes
No

Leptospirosis (canine only):

Does or will your dog drink or play in or near small stagnant ponds of water?

Yes
No

Do you have mice or rats in your house or near your property?

Yes
No

Does or will your dog frequent muddy areas?

Yes
No

Does or will your pet be around livestock farms?

Yes
No

Leukemia (feline only):

Does your cat go outside?

Yes
No

Vaccination Guidelines

Vaccinations are the cornerstone of infectious disease prevention for your pet. The American Animal Hospital Association has established guidelines for appropriate vaccinations of companion animals. Vaccines are divided into two categories: Core vaccinations, which are necessary for all pets regardless of lifestyle, and Non-Core vaccinations, which are recommended based on risk factors.

Core Vaccinations:

Rabies: This vaccination is required by law. Rabies is transmitted by direct contact with the saliva of an infected animal and is almost 100% fatal if contracted. Raccoons and bats, skunks, foxes and woodchucks are all important rabies vectors in Rhode Island. Vaccination begins at 12 weeks of age and is boostered yearly for cats and every 3 years for dogs that are not overdue on their vaccine.

Canine and Feline Distemper vaccinations (DHPP, FVRCP): These viruses can cause fatal intestinal, neurologic, respiratory and liver diseases. Vaccination begins at 6 weeks of age and continues every 3-4 weeks until puppies and kittens four months of age. It is then administered every three years thereafter.

Non-Core Vaccinations (Dogs):

Lyme: Lyme disease is transmitted by infected ticks and is extremely prevalent in New England. This vaccine is appropriate for any dog that is exposed to ticks. The most effective way to prevent transmission of Lyme disease is a combination of vaccination and a reliable flea & tick preventative.

Leptospirosis: This disease is transmitted by the urine of infected animals and can be found in wildlife, livestock and rodent populations. It can cause kidney and liver failure and even death. Infected pets can also transmit disease to their human owners. This vaccine is appropriate for dogs that frequent stagnant bodies of water, muddy areas, have exposure to rodents, or spend time in areas frequented by wildlife or near farmland as these are the places where this bacterium readily grows.

Bordetella: This vaccine protects against one of the causative agents of infectious tracheobronchitis, also known as “Kennel Cough”. This disease can cause anything from a mild cough to severe pneumonia. The Bordetella vaccine is appropriate for dogs that are around other dogs such as when they go to the groomer, dog park, day care, group training classes, or boarding facilities.

Canine Influenza: This is a highly contagious respiratory infection which causes coughing, sneezing, lethargy, fever and even pneumonia. Vaccination is appropriate for dogs that are around other dogs such as when they go to the groomer, dog park, day care, group training classes, or boarding facilities.

Non-Core Vaccinations (Cats):

Leukemia: This virus can affect a cat’s body in a multitude of ways. It can cause cancers to form, various blood disorders and is fatal. This vaccine is recommended for all cats that go outdoors.

Hill & Harbour Veterinary Center Hospital Policies

In order to provide all of our patients and clients with an optimal level of care, Hill & Harbour Veterinary Center has established the following policies:

Appointment Policy

Hill & Harbour Veterinary Center sees patients by appointment only. New patients should arrive 15 minutes prior to their first appointment. Please ensure that all previous medical records have been submitted prior to your pet’s first appointment. By doing so, you will ensure that your pet receives the most appropriate veterinary care at his or her visit.

We make every effort to see patients at their scheduled appointment time. However, emergency cases receive top priority. Any pet in need of critical care that arrives during your visit may result in delays. We would greatly appreciate your understanding when emergency situations arise which require our immediate attention.

Late Appointments

If you are running late for an appointment, please contact our office as soon as possible at (401) 398-7807.

If you arrive more than 10 minutes after your scheduled appointment time, we may need to reschedule your appointment to a later date or time.

No-Show Appointments

Hill & Harbour Veterinary Center reserves the right to require a pre-payment, equal to the exam fee, for an upcoming visit if you have not showed up for an appointment in the past.

Payment Policy

We require payment when services are rendered. We accept Visa, MasterCard, Discover, American Express, cash, and checks. We also accept payment plans through our partner ScratchPay.

For serious, chronic, or complicated cases, our staff would be happy to help you calculate the varying costs of different options for veterinary services presented for your consideration. If you have doubts about approving any veterinary services you elect to receive at Hill & Harbour Veterinary Center, please address your concerns with us before care is administered.

Internet Pharmacy Policy

Hill & Harbour Veterinary Center Veterinary Center offers a number of pharmacy products in-house, which we receive directly from manufacturers or endorsed distributors. Please read our Online Prescription Policy to learn why it’s more beneficial to you and your pet to purchase your pet’s medications from a licensed veterinarian.

New Client Form