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New Client Form
New Patient Form
Whether you’re a first-time pet parent or you’re just adding to your furry family, we can’t wait to meet your new pet. Please fill out the form below.
New Client Form
Congratulations on your new addition! Please note all fields marked with * are required.
Is your pet microchipped?
How active is your pet?
Not very active
Does your cat go outdoors?
Does your dog go to the groomer/daycare/boarding/dog parks?
What are you currently feeding your pet? Please include brand, formula, amount fed and how often, whether canned, dry, or both, as well as any treats, toppers, table scraps, etc.
Is your pet currently taking medications?
Please list all medications including medication name, dose, and frequency of administration.
Do you give your pet any dietary supplements, such as fish oil or vitamins? Do you give your pet any natural/herbal remedies?
Please list all supplements and/or natural herbal remedies including name, dose, and frequency of administration.
Do you give your pet monthly heartworm, intestinal parasite, flea and tick preventives?
Please list all parasite preventives. Please let us know if you give these seasonally or year-round.
Has your pet ever had a negative reaction to medication or vaccinations?
Please describe your pet’s reaction in detail, including which vaccination and/or medication caused the reaction.
Is your pet currently being treated for any medical conditions?
Please describe your pet’s medical condition in detail, as well as response to treatment(s).
How does your pet feel about a visit to the vet?
Eager and excited
Reluctant and fearful
Has your pet shown any avoidance of or dislike of the following? (select all that apply)
Getting into the car or carrier
Entering the clinic/exam room
Other pets or people passing by while in the clinic
Being approached by veterinary staff
Getting on the scale
Phones ringing, loud voices, or other loud noises
Being lifted onto the exam table
Having a rectal temperature taken
Use of instruments, such as stethoscope, otoscope, or ophthalmoscope
Having certain parts of their body touched, such as belly or paws
Specific treatments or tests, such as blood draws, nail trims, or anal gland expression
None of the above
What are your pet’s favorite treats?
Does your pet have any food allergies or sensitivities?
Please list all food items that your pet is allergic to
Is there anything else you would like us to know about your pet’s health or disposition?
Medical Records Upload
Click or drag a file to this area to upload.