New Client Registration Form

Primary Owner *

Email Address *

Address *

City *

Province *

Postal Code *

Phone Number *

Do you consent to receiving text messages? *

Yes, I consent
No, I do not consent

We use text message appointment reminders to confirm upcoming appointments.

Co-Owner's Full Name

Alternative Phone Number

Pet's Name *

Species *

Breed(s)

Colour *

Date of Birth or Approximate Age *

Sex *

Does your pet have any special identification?

Microchip, tattoo, etc.

Is your pet on any medications or supplements? *

Yes
No

If yes, please list them and their dosages:

Are there any current or past medical conditions of which we should be aware? *

Yes
No

If yes, please comment on the condition(s) and indicate if they are current or past conditions:

Is there anything else you would like us to know about your pet and their history?

Has your pet visited any other veterinary practices? If so, please list them.

By providing your previous vet clinic, you are consenting to us contacting that clinic on your behalf to obtain your pet's records.

OWNER'S INFORMATION