New Client Form

Thanks for saving paper and using our digital New Client Form!

Once you submit your completed form, someone from our office will contact you to set up an appointment. And, you won’t have to come in early to fill out any paperwork!

We appreciate you choosing Sardis Animal Hospital for your pet health care needs and we look forward to meeting you both.

OWNER INFORMATION

Full Name *

Spouse/Co-owner Name

Address *

City *

Province *

Postal Code *

Phone Number *

Alternate Number

Occupation / Employer

Work Phone

Email Address *

May we email you with appointment reminders, news, and pet health care resources?

Yes
No

Emergency Contact

Emergency Contact Phone Number

PATIENT INFORMATION

Pet's Name *

Your pet's species *

Your pet's breed

Sex *

Colour/Markings *

Approximate Weight *

Date of Birth or Approximate Age *

Does your pet have an identifying tattoo? If yes, please include details.

Has your pet been microchipped? If yes, what is its ID number?

Does your pet have a rabies tag? If so, what is the issuing organization and ID number?

Previous Veterinary Hospital

Name of Previous Veterinarian

May we request medical records?

Yes
No

Is your pet currently on any medication? If so, what?

Does your pet have any allergies or illnesses? If so, what?

If someone referred you to us, please give us their name so we may thank them.

Should we contact you to make an appointment?

Yes, call me to schedule an appointment.
No, I already have an appointment.

If you already have an appointment, when is it scheduled for?

Please use the following box to give us any other relevant information about your pet.

Security Question *

I HAVE READ AND UNDERSTOOD THE PRIVACY POLICY *

New Client Form

OWNER INFORMATION

PATIENT INFORMATION

Our Cookies

About Cookies

Cookie settings

Functional cookies

Analytics cookies

Marketing cookies