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New Client Form
Please fill out this form if you are a new client ONLY. This is not for appointment requests. Please call if you are already established with us and need make an appointment.
*
NOTICE:
ALL new clients will be required to place a
$60 deposi
t that will count towards their first appointment. MULTIPLE APPOINTMENTS REQUIRE MULTIPLE DEPOSITS. ALL deposits are refundable up until 6PM (close) of the business day before your scheduled appointment.
This is to ensure our availability as well as minimize time wasted due to no-call/no-shows. You will NOT have to put deposits down for future appointments once your pet is established, but you will be charged a $60 missed appointment fee if you do not give a 24-hour advance notice to cancel your appointments in the future.
*PLEASE ALLOW 72 HOURS FOR A RESPONSE. IF YOU SUBMIT YOUR FORM ON A FRIDAY, WE WILL NOT GET IT UNTIL MONDAY AS WE ARE CLOSED OVER THE WEEKEND!
We'll call you and offer appointments as soon as we have them available.
If we do not have an appointment available in regard to your pet's urgent needs,
we will notify you
.
Please fill out everything as accurate as possible!
Client Information
*
Indicates required field
Type of Appointment Needed
*
Urgent: Currently has issues that need to be addressed
Non-Urgent: Needs wellness or other healthy exams
Emergency: PLEASE CALL!
Name
*
First
Last
[object Object]
Email
*
Phone Number
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Pet's Information
Pet Name (1)
*
Species, Select One
*
Cat
Dog
Kitten
Puppy
Gender
*
Spayed Female
Intact Female
Neutered Male
Intact Male
Age, Breed, Color &/or Markings
*
Pet Name (2)
*
Species, Select One
*
Cat
Dog
Kitten
Puppy
Gender
*
Spayed Female
Intact Female
Neutered Male
Intact Male
Age, Breed, Color &/or Markings
*
Pet Name (3)
*
Species, Select One
*
Cat
Dog
Kitten
Puppy
Gender
*
Spayed Female
Intact Female
Neutered Male
Intact Male
Age, Breed, Color &/or Markings
*
Pet Name (4)
*
Species, Select One
*
Cat
Dog
Kitten
Puppy
Gender
*
Spayed Female
Intact Female
Neutered Male
Intact Male
Age, Breed, Color &/or Markings
*
Records / History
*
I am bringing my pet's history or I will upload it here
I would like you to transfer my pet's history from my previous clinic or hospital
My pet has no history or I can not locate it and we are starting fresh
Upload Pet's History
*
Max file size: 20MB
You can upload your pet's history if you have it. If not, please continue to fill out the information for your previous clinic.
Previous Animal Clinic / Hospital
*
Name of where your pet's were previously seen. Put "None" if you do not have a previous veterinarian.
*Put NONE if you do not have a previous clinic, you're bringing your own records, or you are uploading records*
Previous Vet's Phone Number
*
Phone Number of where your pet's were previously seen. Put "None" if you do not have a previous veterinarian.
*Put NONE if you do not have a previous clinic, you're bringing your own records, or you are uploading records*
Name on Account @ Previous Vet
*
*Put NONE if you do not have a previous clinic, you're bringing your own records, or you are uploading records*
Availability
Availability: Choose All That Apply
*
Monday
Tuesday
Wednesday
Thursday
Friday
Mornings (8:30am-12PM)
Evenings (2:30pm-5PM)
Available Anytime
Additional Information
How can we help you?
*
Please tell us about what your pet needs to come see us for: wellness, problems, vaccines, rehab/physical therapy, etc.
Submit
Home
About Us
Our Services
New Client Form
Meet Our Staff
Tour The Facility
Helpful Pet Links
Pet Health News
Emergency & Poison Control Info
Local Rescues & Organizations