COUNTRYSIDE VETERINARY HOSPITAL
  • Home
  • Our Services
    • Acupuncture
    • Boarding
    • Cancer Treatment
    • Dentistry
    • In-House Diagnostics
    • Laser Surgery
    • Microchipping
    • Orthopedic Surgery
    • Soft Tissue Surgery
    • Therapeutic Laser Treatment
    • Ultrasound
    • Wellness Care
  • Our Team
  • Forms & Resources
    • New Client Form
    • Surgical Authorization and Option Consent Form
  • Contact
  • Online Pharmacy
  • Petly
  • Emergency Info
  • Job Opportunities
  • Facebook

New Client Form

* Indicates required field

    Pet Information


    Medical History


    Statement of Ownership

    By checking below, you certify that you are the owner/agent of the animal(s) listed above and that you also authorize the veterinarian to examine, prescribe, or treat the animal(s) above. You understand and agree that you will be held personally responsible for payment for all services provided by Countryside Veterinary Hospital. You further understand and agree that all sums shall be paid at time of service.  If not received within 30-days of bill, a finance charge of 1.5% per month or $5.00 minimum, whichever is greater, shall be charged on the unpaid balance.  If default of payment should occur, you agree to pay accrued finance charge, all costs of collection (including attorney fees) and other court costs incurred. For all new or un-established clients, a deposit of 75% estimated costs will be expected in the event of emergencies.
Submit

Get In Touch

Countryside Veterinary Hospital
Address: 3120 S Woodruff Ave
                  Idaho Falls, ID 83404
Main Phone: 208-522-8010
​Email: countryside.idahofalls@gmail.com

Countryside Pet Center (boarding)
Phone: 208-522-9011

Office Hours

Monday: 7:30 am to 6:00pm
Tuesday: 7:30 am to 6:00pm
Wednesday: 7:30 am to 6:00pm
Thursday: 7:30 am to 6:00pm
​Friday: 7:30 am to 6:00pm
Saturday: Closed
​Sunday: Closed

Helpful Info

ONLINE PHARMACY
EMERGENCY INFO
See your pet on Petly – As your pet's personal health page, Petly is a special place for you and your pet. You're just one click away! – GO TO PETLY
Site powered by Weebly. Managed by IDEXX Laboratories
  • Home
  • Our Services
    • Acupuncture
    • Boarding
    • Cancer Treatment
    • Dentistry
    • In-House Diagnostics
    • Laser Surgery
    • Microchipping
    • Orthopedic Surgery
    • Soft Tissue Surgery
    • Therapeutic Laser Treatment
    • Ultrasound
    • Wellness Care
  • Our Team
  • Forms & Resources
    • New Client Form
    • Surgical Authorization and Option Consent Form
  • Contact
  • Online Pharmacy
  • Petly
  • Emergency Info
  • Job Opportunities
  • Facebook