New Client Form

Save time during your next appointment. Complete your new client form online from any device at any time before your visit.

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New Client Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pets before your visit.

OR

You may use the PDF version by clicking the DOWNLOAD FORM button and completing the printed form by hand. Please bring the completed PDF form for your pet’s first appointment.

DOWNLOAD FORM

Client Information

Date:

Owner's Name-Primary account owner:

Email Address *

Primary Contact Phone:

Mailing Address:

Address Line 1

Address Line 2

City

State

Zip Code

Secondary Account Owner:

Phone:

Additional Persons Authorized to Receive Services on Account:

Who may we thank for referring you?:

In case of emergency who should we contact?:

Phone:

Client Signature:

Staff Signature:

Email

New Client Form

New Client Form

Client Information

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Proudly serving the following communities:

Salem

Stayton

Albany

Sublimity

Lyons

Jefferson

Keizer

Portland