New Client Registration Form

Client Information

Owner Date of Birth:

Pet's Information

By initialing, I understand that the Veterinary Emergency Center of Redlands is not responsible for any lost items (leashes, collars, harnesses, blankets, clothing, etc.) while my pet is in their care. The Veterinary Emergency Center of Redlands encourages owners to remove any personal belongings prior to their visit.

Are you the legal owner?

With any patient suffering from serious illness or injury, complications and problems can occur at any time and the Emergency Pet Hospital of Redlands needs to determine your wishes with respect to the CPR status of your pet. During a cardiac or respiratory arrest, or near arrest situation, it is necessary for the doctor(s} at Emergency Pet Hospital of Redlands to make rapid medical decisions regarding your pet's treatment. CPR (cardiopulmonary resuscitation} is the attempt to revive an animal that has stopped breathing and/or whose heart has stopped beating. CPR may include chest compressions, positive pressure ventilation, emergency drugs, or other medical interventions. Despite the best efforts of the doctor(s} and staff at EPHR, CPR may not restore the pet's life. Furthermore, even CPR that restores a pet's life may not allow for the pet to regain normal mental and physical health.

CPR involves an added financial responsibility of $325.

I have read and fully understand the terms and conditions set forth above.