Create or Update Your Client Profile

Arizona Exotic Animal Hospital provides a full range of veterinary and boarding services to all kinds of exotic pets. We treat and board small mammals, fish, reptiles, amphibians, birds, and more. 

If this is an emergency, please instead call us at 480-275-7017.

Please note you must be 18 years or older to fill out this form, and to make medical and financial decisions for a pet. We request that all pets be brought in an appropriate carrier to our hospitals. Also, do not bring additional pets or dogs to your appointment.

We look forward to meeting your exotic friends. 

Please show your ID to the receptionist to receive a 10% discount.
You must be at least 18 years old to complete this form.
Tell Us About Your Pet
Add Another Pet
If you have another pet you'd like us to care for, tell us here.
How did you hear about us?
Select and describe all that apply!
Hospital Disclosures
Please read and initial the following statements. Our staff will be happy to explain any of these statements prior to your initialing.
I authorize and direct the veterinarians at Arizona Exotic Animal Hospital to examine, diagnose and prescribe as they deem necessary for the patient’s well being. No warranty or guarantee has been made as to the result or cure. ALL FEES ARE REQUIRED TO BE PAID IN FULL UPON COMPLETION OF THE VISIT. We accept cash, Visa, Mastercard, AMEX, Discover and CareCredit. A deposit may be required at the time of admission and the balance paid in full at discharge. If you have any questions about the fees or policies, please alert us prior to services being performed. Accounts not paid within 30 days are subject to an interest finance charge. In the event any balance due is not paid as agreed, the undersigned jointly and severally agrees to pay all cost included in the unpaid balance, including a reasonable collection and /or attorneys’ fees.
I understand that my pet may act differently than it does at home & there is a chance it may bite, scratch, or otherwise attempt to injure anyone, including myself, while handling it. I understand that I should not handle my pet during any procedures and that if I do this waives liability of the hospital if I am injured directly or indirectly by the actions of my pet during said procedures.
I understand that there are few medications specifically licensed for use in exotic pets. I authorize the extra label use of medications on my pets and I understand the potential risks associated with such treatment.
Some medical conditions may be life-threatening and impact the examination of my pet. If a life-threatening emergency is detected while your pet is here, the staff of Arizona Exotic Animal Hospital will try to stabilize your pet unless you initial the “Do Not Resuscitate” below.
I understand that the Mesa office is the only 24 hour location at this time. Other AZEAH locations are not 24-hour facilities, and personnel will not tend to patients beyond regular office hours. I understand that I can request transfer to an emergency veterinary hospital with 24-hour care if overnight hospitalization is required.
Arizona Exotic Animal Hospital may want to use pictures/and or information resulting from the veterinary care of my pet on their website, social media sites, or for other educational purposes. Only the pet’s first name & medical condition will be used. Client name, address & other personal information will NOT be used. I understand that if I choose to revoke this permission, I must notify the hospital in writing.
I understand that I should be 15 minutes early to my appointment to allow adequate check in time. If I am late to my appointment, I may be asked to reschedule. If my pet needs to be worked into the schedule, there will be a late fee associated with this.
Masks are currently not required. I understand that if I feel ill or have a fever, I will reschedule my appointment.
I understand that I will be required to pay a $50 deposit fee when scheduling an appointment. The deposit fee will be applied towards the amount due from the services provided to the patient during the appointment. I understand that if I need to cancel/reschedule the appointment and do not provide a 24-hour notice, I forfeit the $50 deposit.

By signing your name here, you agree this will be used as your signature and you agree to all the terms above. Please ensure your signature is legible on screen! We may ask you to sign again in person at the office if it isn't.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.