Client Forms

Instead of coming to the clinic early and filling out all the appropriate forms by hand, complete your forms online! Fill out the form needed for your upcoming visit, click submit, and all your information will be sent to us securely.

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Pet Information

Financial Policy

Financial Policy

Thank you for choosing Rutland Veterinary Clinic and Surgical Center. We are dedicated to providing exceptional care to all our patients. In order to provide you services with the highest level of quality, we cannot extend credit out of the clinic. Please understand that payment in full is due at the time of service. We may also require a deposit for major procedures. To help you meet your financial responsibility, a detailed treatment plan is available and the following payment options are accepted:

  • Cash, Checks, or Money Orders
  • American Express, Discover, MasterCard, and Visa credit cards
  • CareCredit and Scratchpay

In an effort to offer our clients more personalized financial arrangements, we are pleased to partner with both CareCredit and Scratchpay. Apply online at CareCredit or Scratchpay and please contact our staff with any questions.

By acknowledging the checkbox below, I agree to pay Rutland Veterinary Clinic and Surgical Center (RVCSC) for services rendered and service charges for overdue balances. I agree to pay all collection costs, including collection agency and/or attorney fees.

By acknowledging the checkbox below, I authorize Rutland Veterinary Clinic and Surgical Center to release my pet’s medical and vaccine records, if requested by another veterinarian, boarding facility or grooming facility.
By signing this form, I permit RVCSC to record, own, publish and republish information about me, my pet(s), property and reproductions of my likeness and my voice for educational, marketing, and publicity purposes through any media. I acknowledge that any pictures or recordings taken or submitted then become the sole and exclusive property of RVCSC. I acknowledge that the material I have submitted does not include anything that is copyright protected. I release RVCSC from any and all claims that might arise from the use of these images and recordings.

To Whom it May Concern:
I, owner of the pet listed below, authorize the authorized agent listed below to make emergency veterinary medical decisions, including euthanasia (unless noted below) for the animal described below in the event that I cannot be reached. Where applicable, I have also listed guidelines and limitations of care. I accept financial responsibility for the emergency care of the animal(s).

Other Instructions, if applicable

Please provide a description of what is to be done in place of this procedure/treatment
Grooming will include: Grooming of choice selected above, Ears plucked as needed, Ears cleaned as needed, Toe nails trimmed


If your pet requires sedation for grooming, we will perform a pre-anesthesia examination for his/her safety. Screening blood tests will be done unless they have been done within the last 6 months (or within 12 months for pets under 7 years of age).

Age 7 and older Cost

  • Pre-anesthesia exam $ 38
  • Blood tests $148 CBC/Mini/Lytes + Bio
  • Anesthesia $ 45
  • Total $238 + grooming

Under Age 7 Cost

  • Pre-anesthesia exam $ 38
  • Blood tests $82 Mini + Bio
  • Anesthesia $ 45
  • Total $172 + grooming