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New Patient Form
Pet Name
First
Specieis
Breed
Color
Date of Birth / Approximate age
Sex
Male
Female
Spayed
Neutered
Name of previous veterinarian
Would you like us to contact them to get your records transferred?
Yes
No
Current Medications
History of allergic reactions
Any behavioural issues?
Number of hours spent outside during the day
Other pets in the house?
Does your pet get regular exercise?
Please list any previous surgeries
What is the primary purpose of this pet?
Companion
Protection
Service Animal
Authorization
I hereby authorize the veterinarian to examine, prescribe for, or treat the above described pet. I assume responsibility for all charges incurred in the care of the animal. I also understand that these charges will be paid at the time of release and that a deposit may be required for surgical treatment.
Do we have your permission to use your pets photo on our website and social media sites?
*
Yes
No
Signature of Owner
*
Date
*
MM
DD
YYYY
New Clients
About Us
Our Team
Location & Hours
What To Expect
Take A Tour
Forms
Pet Health and Care Guides
How-To Videos
Contact Us