Equine New Patient Registration

Can you receive texts on this cell phone?(Required)
Preferred Payment Method(Required)

Horse Information

i.e. Registered Name
MM slash DD slash YYYY
(if different than home)
Stable Address
Is horse insured?(Required)
(serious illness, lameness, colic, etc.)
Trainer Name

Submit Form

Accepted file types: jpg, gif, png, pdf, mp4, mov, Max. file size: 32 MB.
Payment Policy: In order to keep costs low for all clients, please note that payment is due at the time of service. We accept cash, check, Care Credit (limited promotions), and Visa, Discover, and MasterCard credit cards. Please be prepared to pay your balance in full before departure. Thanks! ~The CEC Team
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