Offering State-of-the-art Medical Care, Comprehensive Diagnostics & Outstanding Customer Services on St Croix, USVI.

Your Pet's Health is Our Passion!


Sugar Mill Veterinary Center
Dr. Stacia Jung, VMD
4220 La Grande Princesse
Christiansted, VI 00820
St Croix, USVI

Tel 340.718.0002
Fax 340.718.0003

info@sugarmillvetcenter.com

EMERGENCY: 340.227.5627

At Sugar Mill Veterinary Center
you know what might come through
our doors!

 {Client Forms}

New Client

Rx Refill

Change of Address

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New Client Check In

If you would like to make an appointment, you can assist us to expedite your check in by submitting this form.

Thank you for your cooporation in letting us assist you.

Form - New Client

Name & Email (required)
First Name (required)
Last Name (required)
Address (required)
Street Address (required)
City (required)
State/Province (required)
Zip/Postal Code (required)
,
Daytime Phone (required)
Phone TypePhone Number (required)
Evening Phone (required)
Phone TypePhone Number (required)
E-Mail Address :
Pet's Name (required)

Age: Years, Months

Type of Pet (required) :
Breed:

Sex: (required)
Male
Female


Neutered/Spayed
Neutered
Spayed


Are your pet's vaccines current?
Do you have your pet's medical records?
Medical records at another veterinary Practice?
Yes
No


Name of Former Veterinary Practice

May we request a transfer of records?
Yes
No


Would you like us to call you for your appointment
Reasons or conditions that prompted your visit?

Special requests or conditions?

Please list any additional pets here

Please Read
I understand, by indicating I agree and submitting this registration, that I am responsible for any charges incurred by my pet while in the care of the doctors at Sugar Mill Veterinary Center and that charges are due and payable at the time of service. Any balance that is not paid at the time service is rendered will accrue a monthly finance charge of 1.5% and a $5 monthly billing fee. Any balance that I leave unpaid may be forwarded to a collection agency, and may incur a collection fee for which I am liable, in addition to monthly finance charges.
I have read this statement and -
I Agree
I Disagree



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