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Your Pet.
Your Vet.
Your Choice.

CLIENT AND PATIENT REGISTRATION FORM

Please take a moment to enter the information below as we will be using this to create your account and patient files in our veterinary information management software. We may use the information provided to contact you, including electronic communications, to assist in the health care of your pet. Email addresses and phone numbers will only be used by our office to communicate with you concerning your pet including any recalls of products and medication that you may have used on your pet and as such is required. We do not share your information with anyone else for any reason except as may be required by law. We will only disclose personal information about you and your pet in circumstances where we believe it will be beneficial to the continued care and good health of your pet, such as a file transfer to another animal hospital or veterinary referral service. All fields are mandatory in order to start a new account and patient file.


Pet Information

In order to prevent medical complications, if you are transferring from another veterinary service provider, please enter the information so that we can get the medical records. If you are a new pet owner, or have a puppy or kitten without a veterinary provider, you can leave this area blank.

Previous Veterinary Information

Consent

Signature

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OR BARK, OR EVEN MEOW!

We provide clear communication with our clients to
avoid any unnecessary costs and build trust.

Community Votes Chatham-Kent 2024 Platinum Winner Vet Clinics
Mike & Angela