New Client Form

We must have your pet's completed form on file prior to your first appointment. By pressing the "Submit" button, this form will automatically be sent to our office.

Fields marked with an * are required.

Your Information

Name *

First

Last

Phone Number *

Email *

Home Address

Street Address *

Street Address Line 2 (If Applicable)

Gate Code (if applicable)

City *

State *

Zip Code *

Pet #1 Information

Canine

Feline

Male

Female

Spayed or neutered?

Neutered

Spayed

Add another pet

Additional Information

First vet visit for your pet? Just write "None".

Social media

Facebook

Instagram

Nextdoor

Search & advertising

Google search

Print advertisement

Around town

Spotted our truck around town

Friend/ Referral

Something else

Other

Behavioral Questionnaire

1. Highly Unlikely - Pets have no history of aggression; are submissive or non-aggressive

2. Unlikely - Pets are mostly submissive or nonaggressive; Generally stranger-friendly

3. Possibly - Pets are generally non-aggresive, but one or more pets has shown situational aggression with strangers or in unfamiliar situations

4. Likely - One or more pets have tendency to show aggression with strangers or when placed in unfamiliar situations

5. Highly Likely - One or more pets often behaves aggressively with strangers or when placed in unfamiliar situations

Terms Agreement: Behavior Disclosure

We go above and beyond to accommodate each pet that needs our care. After we have evaluated your pet's temperament, we may find it medically necessary to intervene with additional measures before we can handle your pet safely. If this is the case, we can implement several strategies and tools to help allow for a more successful and stress-free visit subsequently.

However, in cases of extreme behavioral disorders - ex. high levels of aggression - an instance might arise in which we are unable to treat your pet, due to safety concerns. If such an instance arises, you will still be held financially responsible for a trip fee to your residence, in order to cover travel costs.

By checking the box below, I agree to these terms. *

I agree