Name: Hanging Rock Animal Hospital
Address: 1910 Loch Haven Dr,, Roanoke, VA, 24019, US
Telephone: (540) 562 -4596
Price range: $$

Date*
Date Format: MM slash DD slash YYYY
Name*
First Last
Please select the one that best describes you.*
- I am an established client.
- I am a new client that wishes to establish my pets at HRAH!
What is your pet's name?*
What is your pet's gender?*
What is your pet's species?*
Please list your cat's breed and color.
If your cat's breed is unknown, please notate if Domestic Short Hair, Domestic Medium Hair or Domestic Long Hair.
Please list your dog's breed or predominant breed(s) if a mix. Please note color of your pet.
What type of animal do you have?
Please include as much information as possible.
Email*
Preferred phone number to use:*
List contact numbers below.
Home Phone*
Cell Phone*
- Check this box if you wish to opt out of SMS messages at the number provided.
Other Phone*
Work Phone*
Employer Name
Leave blank if Retired or Unemployed.
Work Phone
Secondary Contact Name
Leave blank if there is no secondary contact.
First Last
Secondary Contact's Relationship to Primary
Secondary Contact Phone*
- Check this box if you wish to opt out of SMS messages at the number provided.
Secondary Contact's Employer Name
Leave blank if Retired or Unemployed.
Secondary Contact's Work Phone*
Secondary Contact Email
What locality do you live in?*
Other Locality:*
Address*
Street Address PO BOX (if any) City State ZIP Code
Emergency Contact Name
Used only if primary and secondary contacts cannot be reached.
First Last
Emergency Contact Phone*
Photo Release*
Here at Hanging Rock Animal Hospital we like to take a lot of pictures and videos! You and your pet may be in those pictures and/or videos. Do we have your permission to use these images? (Such use may include the display, distribution, publication, transmission or otherwise use of photographs, images and/or videos taken for use in materials that include, but may not be limited to, printed materials such as brochures, newsletters, videos, and digital images used on Hanging Rock Animal Hospital's website and social media, such as Facebook.)
- Yes, please!
- Yes, sure, but keep me out of the pic!
- No, thank you.
How did you hear about Hanging Rock Animal Hospital or who can we thank for your referral?*
Who can we thank for your referral?*
Please tell us how you heard about Hanging Rock Animal Hospital!*
For the Health of our Patients:*
To prevent the spread of infectious disease and parasites, any hospitalized or boarding animals must be current on all core vaccines/titers and free of internal and external parasites. Your pet will be updated as deemed medically appropriate by the Veterinarian.
- By checking this box I confirm that I have read, understand and agree to this policy.
Payment is Due When Services are Rendered:*
To my knowledge all of the above information is true and correct. I/we agree to assume all financial responsibility for all services rendered, procedures performed, medications administered or dispensed, and hospital fees. Payment is due at the time services are rendered. We will gladly prepare a written estimate if you desire, just ask any of our staff members. We accept American Express, Cash, Check, Visa, Mastercard, Discover, Pay Pal and Care Credit. I/we agree to be responsible for all costs related to any collection of my account including attorney’s fees in the amount of thirty-three and one-third percent (33.3%) of the outstanding balance at the time a collection attorney contacts me, which I hereby agree is reasonable. I further agree to pay interest at the rate of one and one-half percent (1 ½%) per month on any amount due Hanging Rock Animal Hospital, which remains unpaid thirty (30) days after its due date.
- By checking this box I confirm that I have read, understand and agree to this policy.
Verification Initials*
By initialing this line, I hereby consent to have read this form and completed to the best of my knowledge.

Client Registration Information Form

Date*
Date Format: MM slash DD slash YYYY
Name*
First Last
Please select the one that best describes you.*
- I am an established client.
- I am a new client that wishes to establish my pets at HRAH!
What is your pet's name?*
What is your pet's gender?*
What is your pet's species?*
Please list your cat's breed and color.
If your cat's breed is unknown, please notate if Domestic Short Hair, Domestic Medium Hair or Domestic Long Hair.
Please list your dog's breed or predominant breed(s) if a mix. Please note color of your pet.
What type of animal do you have?
Please include as much information as possible.
Email*
Preferred phone number to use:*
List contact numbers below.
Home Phone*
Cell Phone*
- Check this box if you wish to opt out of SMS messages at the number provided.
Other Phone*
Work Phone*
Employer Name
Leave blank if Retired or Unemployed.
Work Phone
Secondary Contact Name
Leave blank if there is no secondary contact.
First Last
Secondary Contact's Relationship to Primary
Secondary Contact Phone*
- Check this box if you wish to opt out of SMS messages at the number provided.
Secondary Contact's Employer Name
Leave blank if Retired or Unemployed.
Secondary Contact's Work Phone*
Secondary Contact Email
What locality do you live in?*
Other Locality:*
Address*
Street Address PO BOX (if any) City State ZIP Code
Emergency Contact Name
Used only if primary and secondary contacts cannot be reached.
First Last
Emergency Contact Phone*
Photo Release*
Here at Hanging Rock Animal Hospital we like to take a lot of pictures and videos! You and your pet may be in those pictures and/or videos. Do we have your permission to use these images? (Such use may include the display, distribution, publication, transmission or otherwise use of photographs, images and/or videos taken for use in materials that include, but may not be limited to, printed materials such as brochures, newsletters, videos, and digital images used on Hanging Rock Animal Hospital's website and social media, such as Facebook.)
- Yes, please!
- Yes, sure, but keep me out of the pic!
- No, thank you.
How did you hear about Hanging Rock Animal Hospital or who can we thank for your referral?*
Who can we thank for your referral?*
Please tell us how you heard about Hanging Rock Animal Hospital!*
For the Health of our Patients:*
To prevent the spread of infectious disease and parasites, any hospitalized or boarding animals must be current on all core vaccines/titers and free of internal and external parasites. Your pet will be updated as deemed medically appropriate by the Veterinarian.
- By checking this box I confirm that I have read, understand and agree to this policy.
Payment is Due When Services are Rendered:*
To my knowledge all of the above information is true and correct. I/we agree to assume all financial responsibility for all services rendered, procedures performed, medications administered or dispensed, and hospital fees. Payment is due at the time services are rendered. We will gladly prepare a written estimate if you desire, just ask any of our staff members. We accept American Express, Cash, Check, Visa, Mastercard, Discover, Pay Pal and Care Credit. I/we agree to be responsible for all costs related to any collection of my account including attorney’s fees in the amount of thirty-three and one-third percent (33.3%) of the outstanding balance at the time a collection attorney contacts me, which I hereby agree is reasonable. I further agree to pay interest at the rate of one and one-half percent (1 ½%) per month on any amount due Hanging Rock Animal Hospital, which remains unpaid thirty (30) days after its due date.
- By checking this box I confirm that I have read, understand and agree to this policy.
Verification Initials*
By initialing this line, I hereby consent to have read this form and completed to the best of my knowledge.

“

Hanging Rock Animal Hospital is the BEST in the Roanoke Valley. Dr. Honeycutt and "Dr. Todd" are knowledgeable amazing vets. Their entire staff are caring compassionate people who take their time to know all of the animals and humans that walk through their door. I would and have recommended Hanging Rock Animal Hospital to everyone.
Sondra Stamper

Payment Options

There are many different ways to pay that suit your budget. Payment options include:

Contact Us

1910 Loch Haven Dr,
Roanoke,VA 24019

(540) 562 -4596

info@hrah4u.com

Hours

Monday – Friday:
8:00 am – 6:00 pm
Saturday:
8:00 am – 4:00 pm
Sunday:
Closed

*Closed from 12:00 pm – 1:30 pm every Thursday of each month for staff development

Holiday Closures
*Close at noon on Christmas Eve and New Year’s Eve
*Closed on Christmas and New Year’s Day
*Closed: Memorial Day, 4th of July, Labor Day and Thanksgiving Day