New Clients at Canine Vet Care

Thank you for considering us as your provider of veterinary services. We are dedicated to maintaining your dog’s health and look forward to many more years together.

Please complete this form as fully as possible before your first appointment, which will help expedite the registration process and give us valuable insight into providing optimal care for your dog. Please note that required sections are marked with a red asterisk.

Primary Phone(Required)

Co-owner's Name & Contact #

If Other, please specify:

If Personal Referral, is there someone we can thank for this referral?

Please use this area to give us any other relevant information about yourself or your family

Pet Information(Required)

Breed (if known)(Required)

Special Identification (tattoo, microchip, etc.)

Previous Veterinary Practice (if any)

Previous Veterinarian (if any)

If Yes, please list the medication or supplement

What food does your pet eat?

If Yes, please list the allergies and reactions

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

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

Second Pet Information