Client/Patient Information Sheet

If you are new to Pet Vet, or you have a new pet that will be joining the Pet Vet family, simply fill out our new client form and allow us to introduce you to your pet’s new best friends!

Information

Owner's Name
Co-owner / Spouse Name
Address
Pet vet utilizes an in-house email and text messaging system for vaccines and appointments. Do you also want to receive reminder postcards?
Phone number
Email
Employer
Referred by

Pet Information

Pet's Name
Date of Birth or Age
Breed Type
Color / Markings
Species
Sex of animal
Spayed / Neutered
Does pet have microchip?
Microchip Number
Any allergies
Current Medications or special diets
Previous medical problems or surgery
Has your pet had vaccinations in the past year?
Has your pet ever had a professional dental cleaning?
Is your pet on heartworm prevention monthly?
Photo of your pet
* * Photo identification may be required at the time of payment. Thank you for coming to Pet Vet Roanoke, LLC for your pet's health care!