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New Patient Form

Complete your New Patient Form online!

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Complete at your convenience.

Please fill out the new patient form below. Please provide all information as completely as possible. Thank you for choosing Finan Animal Hospital.

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Medical History

We are so excited to see you! Please complete this form before your visit. If you have any questions, please feel free to contact us!

Owner Name:(Required)

Co-owner name:

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Alternate Phone

Email(Required)

County(Required)

Patient Information

Patient Name(Required)

Species(Required)

Patient DOB(Required)

Sex(Required)

Color(Required)

Breed(Required)

Previous Veterinarians:

The information you provide below about your pet is vital to our doctor and nurses’ ability to identify or prevent health problems. Please do not hesitate to ask any questions concerning any aspect of your pet's care. Now let us learn more about your pet! We want your pet to enjoy this visit! Please help us by telling our team what your pet likes and dislikes.

How does your pet feel about seeing the veterinarian?(Required)

Excited

Alert

Scared

Anxious

Angry

Is it okay for us to give your pet food rewards (treats)? (Please let us know if there are any household allergies, i.e. peanut butter.)(Required)

Has your pet ever had an adverse medical reaction to any type of vaccination, medication, or anesthetic? Yes/No, if yes-please explain the reaction.(Required)

History & Environment

How long has your pet lived with you?(Required)

Where did you get your pet? Breeder, Private Home, Shelter, Pet Store, Stray(Required)

Does your pet frequent daycare, boarding facilities, dog parks or loves to travel with you?(Required)

Yes

Does your pet go outdoors?(Required)

Yes

Does your pet ever drink from streams, lakes, creeks, or rivers?(Required)

Yes

Has your pet ever been treated for any previous illnesses, accidents, or surgeries? Yes/No, if yes, please explain:(Required)

Has your pet been spayed or neutered? Spayed/Neutered/No-still intact(Required)

Has your pet had his/her teeth cleaned professionally?(Required)

Yes

Do you do any at-home dental care?(Required)

Yes

Diet

What type of food does your pet currently eat? Dry/Canned/Other(Required)

Brand, Amount and Frequency

Does your pet receive any vitamins or supplements?(Required)

Yes

Does your pet eat people's food?(Required)

Yes

Does your pet eat treats?(Required)

Yes

Does your pet have food sensitivities or allergies to anything?(Required)

Medications

What heartworm/parasite preventative do you give to your pet and how often?(Required)

Has your pet ever been prescribed medication to help with a visit to the veterinarian?(Required)

Yes

We love social media! Do we have permission to share your pet's image and story on our social media, website, Facebook and other forms of related media? Your personal information will never be shared.(Required)

Yes

List all pets names in household

Please attach any records you may have and a cute picture of your pet for their chart!

Max. file size: 50 MB.

Client/Owner Signature(Required)

Client/Owner Name(Required)

Date(Required)

MM slash DD slash YYYY

Consent to Obtain Medical Records

Complete and accurate medical records are necessary for us to review prior to your pet’s appointment. The ability to review your pet’s medical history before the first appointment will allow us to provide exceptional care that is tailored and timely. It will prevent unnecessary duplication of laboratory tests and ensure that treatments that were not effective in the past will not be repeated, allowing the process of diagnosing and treating a medical problem to be sped up (and saving you unnecessary costs). Please provide us with the name(s) of the previous clinics, speciality, or emergency hospitals where your pet has been seen. If you have recently adopted your pet, please send us all records you have received from the adoption agency. It is important that we have these records at least 24 hours prior to your appointment.

Previous veterinary clinic names:(Required)

Client/Owner Signature(Required)

Client/Owner Name(Required)

Date(Required)

MM slash DD slash YYYY

Rabies Immunization Policy

Rabies vaccination of ALL cats and dogs is required by Illinois law. This applies to all pets, including “indoor only” cats.

New patients must provide proof of current rabies immunization prior to first visit. If no proof can be provided, your pet will receive a rabies vaccination at their first visit.
By law, a physical examination by a veterinarian must take place at the time of rabies immunization. Rabies immunizations cannot be administered by a veterinary technician or during a technician office visit. Please note this is Illinois state law and is non-negotiable.
Rabies immunizations will thereafter be updated at the time of a pet’s annual examination.
Clients who refuse rabies immunization for their pets or do not return for annual immunizations will be discharged from the practice for failure to comply with policy practice and state law.

Thank you for your understanding and cooperation.

Client/Owner Signature(Required)

Client/Owner Name(Required)

Date(Required)

MM slash DD slash YYYY

Prescription Refill Policy

We require 24 hrs notice for routine refills.
We require 48 hrs notice for controlled substance refills.
You may request refills from the clinic or from our online pharmacy (via our website).
Any prescription requests for online pharmacies outside of Finan Animal Hospital require a written prescription which you must pick up here at the clinic.
For prescriptions requested to human pharmacies(Costco, Walgreens, CVS), Finan Animal Hospital will call these in for you.
For all prescriptions outside of Finan Animal Hospital, you will be required to sign a prescription waiver before the prescription can be released to you.
If you request a prescription for same day pick up, a rush fee of $10.00 will be applied to your invoice. We require 2 hrs filling time for these requests. Controlled substances cannot be filled on same day requests.

Client Signature:(Required)

Client Name Printed:(Required)

Date(Required)

MM slash DD slash YYYY

Financial Policies

At Finan Animal Hospital we strive to provide premium veterinary care for our patients. We can continue to offer such care and maintain a well-equipped, properly staffed facility only if we receive prompt payment for our services and products.

Having a pet is a special privilege, not a right. With that privilege comes the financial responsibility of providing quality preventative & medical care for your pet. With that in mind, please read the following financial policy:

We require a credit card on file. Our payment processing company (Payjunction) hosts your credit card information and has several security requirements to protect credit card data and complies with the Payment Card Industry Data Security Standards (PCI-DSS). We can only see the last 4 digits of your credit card in our system. Our employees never have access to your card information.
If you do not feel comfortable with keeping a credit card on file, as an alternative, you will be asked to leave an $87.00 deposit on your account. This is shown as a credit on your account and is not applied to any services or appointments outside of a missed or canceled appointment. If you miss or cancel your appointment with less than 24 hrs notice, the credit will be forfeited. You will need to provide another deposit before future appointments can be scheduled.
Full payment is due when services are rendered or pharmacy items are dispensed. We accept Cash, Care Credit, and all major credit cards. We do NOT accept checks.
If you are unable to pay your bill, you may apply for Care Credit. Care Credit is a medical credit company which provides full payment for veterinary care for eligible clients and accepts monthly payments until the balance is paid in full. We do NOT have payment plans.
Our nurses or doctors will provide you with an estimated treatment plan prior to performing any services. Only persons over the age of 18 may sign treatment plans.
If you are unable to pay for all recommended services and inventory items, the doctor can help you decide which are most important for your pet that day & which can wait until you are able to provide payment.
If you are concerned about your ability to financially care for your pet, we strongly recommend you consider a pet insurance policy.
A booking fee of $85.00 is due at the time of scheduling surgical, dental, and ultrasound procedures. It is non-refundable if canceled with less than 24 hrs notice or you do not show for your appointment.
If you do not pay your invoice at time of services rendered, you and your pet(s) may be dismissed from Finan Animal Hospital at the discretion of management.

Thank you for your understanding and cooperation.

Client/Owner Signature(Required)

Client/Owner Name(Required)

Date(Required)

MM slash DD slash YYYY

Cancellation Policy

Finan Animal Hospital is a premier veterinary clinic, providing 30-45 minute appointments tailored to each individual patient. Each time a patient misses an appointment without providing proper notice, another patient is prevented from receiving care.

In order to continue providing our patients with this high standard of care, we have implemented the following missed appointment/cancellation policy.

Cancellation Policy:

All requests for cancellation and/or rescheduling must be made at least 24 hours in advance of the scheduled appointment.

If you have made a same day appointment, you acknowledge your commitment to come in for that scheduled time. If you cancel your same day appointment, this will be considered less than 24 hrs notice.

If you are late 15 mins or more for your scheduled appointment, it will be considered a missed appointment and will be rescheduled.

1st time: We will gladly give you the courtesy of waiving the no-show, late or cancellation/reschedule fee as we understand that emergencies do occur.

2nd time: You will be charged the cost of the appointment you are missing if you fail to cancel/reschedule 24 hours prior to your scheduled appointment. We will charge the credit card on file.

3rd time: If a third no show, late or cancellation/reschedule without 24-hour notice should occur you will be required to prepay for all future appointments with a non-refundable booking fee or you and your pet(s) may be dismissed from Finan Animal Hospital at the discretion of management.

Thank you for your understanding and cooperation as we strive to best serve the needs of all our patients.

Client/Owner Signature(Required)

Client/Owner Name(Required)

Date(Required)

MM slash DD slash YYYY

Patient Dismissal Policy

The veterinarian-client-patient relationship (VCPR) is the basis for interaction among veterinarians, their clients, and their patients and is critical to the health of animals.

Illinois law requires a current VCPR in order for us to provide continued care for your pet. This means each pet must be examined by a veterinarian once a year.

No person may practice veterinary medicine in the State except within the context of a veterinarian-client-patient relationship. A veterinarian-client-patient relationship cannot be established solely by telephonic or other electronic means.

Although the following list is not exhaustive, we may choose to terminate your VCPR under the following circumstances:

Lapse in VCPR: Pet owner understands that Veterinarian-Client-Patient relationship will lapse if their pet has not been examinedby a veterinarian at our hospital within the last 12 months.

Treatment nonadherence: The pet owner does not or will not follow the treatment plan or the terms of illness management, or discontinues medication or therapy regimens prior to completion.

Follow-up noncompliance: The client repeatedly cancels follow-up visits or fails to keep scheduled appointments with our doctors or nurses.

Office policy nonadherence: The client fails to observe office policies, such as those implemented for prescription refills or appointment cancellations.

Verbal abuse or violence: The client, a family member, or a third-party caregiver is rude, uses disparaging or demeaning language, or harasses office personnel or other patients, visitors, or vendors; exhibits violent or irrational behavior; makes threats; or uses anger to jeopardize the safety and well-being of any person or patient present in the office.

Display of firearms or weapons: The client, a family member, or a third-party caregiver wields a firearm or weapon on the premises.

Inappropriate or criminal conduct: The client exhibits inappropriate sexual behavior toward providers or staff or participates in drug diversion, theft, or other criminal conduct involving the practice.

Nonpayment: The client does not adhere to the financial policy. All payment is due at time of service.

Client/Owner Signature(Required)

Client/Owner Name(Required)

Date(Required)

MM slash DD slash YYYY

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Phone

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Phone

(630) 985-2777

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Email

info@finananimalhospital.com

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Location

7940 Lemont Road Downers Grove IL 60516

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Hours

Mon: 8:00 am – 6:30 pm
Tues: 8:00 am – 5:30 pm
Wed: 8:00 am – 6:30 pm
Thurs: 8:00 am – 5:30 pm
Fri: 8:00 am – 5:30 pm
Sat: Closed
Sun: Closed

Get In Touch

If you are a current client and have a question for the team, please complete the form below. A team member will get back to you as quickly as possible. New clients – please reach out via phone at (630) 985-2777.

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Last

Email *

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How can we help you? *

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Our Staff Reviews

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Super friendly staff! They always put non-skid mats for my older dog with mobility issues & make sure my anxious dog has a fear free experience. I’ve had issues at other offices using muzzles, making my dogs feel more defensive & fearful. It can be terrible seeing your dog in fear as they’re “taken in the back”. We’ve never had that experience here, the staff are so comforting & being able to stay in the room with me really puts my pups at ease.

Jessica E.

I can’t give enough praise to Dr. Finan and the rest of the staff. My senior dog Stanley was diagnosed with a very rare issue with his sweat glands that caused him to have large cysts that weee infected. Thanks to Dr. Finan they were removed and I am starting to see my boy feeling so much relief and starting to act like his old self again. Thank you Finan Animal Hospital!

April S.

Dr. Finan is the best! My pets are so well cared for, and Dr. Finan is such a comforting presence to both my dog and my cat (and ME!) She truly listens to my concerns, and tries to find solutions that focus on their individual needs & fears as well as factoring in what we as a family are best able to afford. The staff are all just as kind and caring and really make you feel welcome.

Aimee D.