New Client FormWelcome to East Emporia Veterinary Clinic

We’re excited to welcome you and your pet! This form helps us collect essential information so we’re ready for your first visit. Completing it ahead of time shortens wait times and allows us to focus on your pet’s care right away.

Complete the New Client Form

Veterinary Service Agreement

If credit is extended, the applicant shall be deemed to have agreed to the following terms and conditions. Terms, if not otherwise specified, are net 30 days. An interest rate of 1.5% per month (annual percentage rate of 18%) will be added, starting 30 days from the date of the first statement. No purchase will be financed for over 90 days.

If accounts are not promptly paid when due, the applicant's name may be listed with any credit reporting service. Should it become necessary to place this guaranty with any attorney for collection, suit, or legal action. I/We hereby agree to pay all such costs or such collections, suit or other legal action, including the reasonable costs of action, including, but not limited to, court costs, attorney fees and collections agency fees, except that such costs of collection: 1) may not include costs that were incurred by a salaried employee of the creditor or its assignee: 2) may not include the recovery of other attorney fees and collection agency fees: 3) shall be 33% for the unpaid debt after default or $250.00, whichever is greater.

By signing below, you agree to the above statement and that the above information is correct to the best of your knowledge. You also agree that a digital signature is complete.

Clear Signature
Have questions before your appointment? Call us at (620) 343-7682 or email eastemporiaveterinaryclinic@gmail.com.

Proudly serving families across Emporia, KS and Lyon County.