New Client Form | Sawmill Animal Hospital

Welcome new clients!

Thank you for giving us the opportunity to care for your pet. We’ll be happy to answer any questions you have about your pet’s health.

To insure the best care possible, please take the time to fill in this form completely. Thank you!

Download New Patient Form

"*" indicates required fields

Name

This field is for validation purposes and should be left unchanged.

Select a Location

Location**

Registration

First Name

Last Name

Main Phone**

Address**

Street Address* City* State* Zip Code*

Place of Employment

Email Address

Spouse's Name

Spouse's Phone

How did you learn about us?

If recommended, whom may we thank?

Number of Pets

Dogs

Cats

Other

Reason for Visit

Pet Health History

Pet's Name

Species

Breed

Color

If Species is 'Other', Please Specify

Date of Birth

Age

Sex

Neutered or Spayed

Vaccination History

300 words max

Authorization

I hereby authorize the veterinarian to examine, prescribe for, or treat the above described pet I assume responsibility for all charges incurred in the care of this animal. I also understand that these charges will be paid at the time of release and that a deposit may be required.

Owner Signature*

Method of Payment*

If 'Other', Please Specify.*

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