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New Patient Form

Thank you for trusting PetVet365 to care for your pet. As Fear Free Certified Professionals, we want to make your pet’s veterinary experience as enjoyable and as stress-free as possible. As such, it’s important for us to understand what your pet might find upsetting. The information will help us to adjust our care to better serve and comfort your pet. Please answer the following questions to the best of your ability so we can take into consideration both your and your pet’s preferences.

Location

Owner Information

Address(Required)
Preferred Communication(Required)
Permission to use pictures, history, or medical information about your patients in the media?(Required)

Patient Information

Pet Species(Required)
MM slash DD slash YYYY
Pet Sex(Required)
Is pet spayed/neutered?(Required)
Is pet microchipped?(Required)

Payment Policy: FULL PAYMENT IS EXPECTED UPON RENDERING OF SERVICE. Alternative payment plans must be discussed prior to the start of treatment. Deposits are required on major/surgical cases, trauma cases, and emergency work where hospitalization is required. There is a fee for all returned checks. Outstanding balances on accounts may result in account information being sent to a collection agency.

I accept terms & conditions of payment policy(Required)

Fear Free Pre-Visit Questionnaire

Does your pet show any reluctance to getting in the carrier or car?(Required)
During travel to the veterinary hospital, does your pet do or display any of the following:(Required)
Does your pet prefer:(Required)
Check any situations listed below that your pet has shown avoidance or dislike of in the past. You can add additional comments at the end.
MM slash DD slash YYYY
I declare that the info I've provided is accurate and complete.(Required)
I agree to receive email and text communication from PetVet365.