New Patient Form Dermatology

New Patient Form – Dermatology

    Client Info

    Patient Info

    Has your pet ever been out of your home state or the United States?

    Are any of the other pets affected by the problem?

    Do any human members of the household have skin problems?

    Grooming History

    Pet Medical Information

    Reproductive History

    Please list any other information that you think may be helpful.



    Payment is due as services are rendered. The balance will be due upon discharge from the hospital. You may pay by cash, Care Credit, or accepted credit cards.

    In order to avoid misunderstandings, please let us know immediately if these terms are not satisfactory. In the event payment is not made at the time of service, it is our policy to apply a service charge to accounts with a balance.

    Apex is easily accessible from Denver, Boulder, Colorado Springs, Castle Rock, Highlands Ranch, Littleton, Aurora, Parker, and other Denver Metro areas.

    We are located in the VRCC Imaging Center at:

    (303) 810-6029

    FAX (303) 991- 7913

    945 West Jefferson Avenue Englewood, CO 80110

    Hours of clinical operation:
    Mon – Thur 8:00am – 5:30pm

    Phone Availability:
    M-F 8am – 11pm

    Phone Availability (Weekend):
    9am – 5pm