New Client Form

Client Information

Owner's Name *

First*

Last

Partner/Alternate Owner's Name

First

Last

Appointment Date / Time*

Primary Cell Number*

Secondary Cell Number

Home Contact Number

Client Contact Information

Email Address*

Physical Address*

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Driver's License #*

Issuing State*

Owner's Date of Birth*

Exp. Date*

Note: We DO NOT accept checks

Pet Information

Pet Name	Pet Age	Pet Breed	Pet Color	Pet Sex	Neutered/Spayed	Pet Species	Pet Weight	Microchip Number

Swipe to scroll

Pet Insurance (If any)

Does your pet have any food allergies?*

Yes

Medication allergies?*

Yes

Does your pet have any past or present injuries or health concerns?*

Yes

Are vaccinations up to date?*

Yes

Not Sure

Please list previous veterinarian (if applicable)

Please upload any medical records for your pet(s).

Max. file size: 256 MB

My pet becomes unfriendly when:

Grabbed by collar

Cage aggressive

Touched on mouth

Hugged

Touched on ears

Touched on back

Around other dogs

Touched on paws/tail

I consent and authorize OAVH to take my pet(s) photos and post it on their social media.*

I consent

I DO NOT consent

Consent for Examination and Treatments

I consent

New Client Form

Navigation

Quick Link

Look Book

New Client Form

Client Information

Owner's Name *

Partner/Alternate Owner's Name

Appointment Date / Time*

Primary Cell Number*

Secondary Cell Number

Home Contact Number

Client Contact Information

Email Address*

Physical Address*

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Driver's License #*

Issuing State*

Owner's Date of Birth*

Exp. Date*

Note: We DO NOT accept checks

Pet Information

Pet Insurance (If any)

Does your pet have any food allergies?*

Medication allergies?*

Does your pet have any past or present injuries or health concerns?*

Are vaccinations up to date?*

Please list previous veterinarian (if applicable)

Please upload any medical records for your pet(s).

My pet becomes unfriendly when:

I consent and authorize OAVH to take my pet(s) photos and post it on their social media.*

Consent for Examination and Treatments

Signature of Owner/Guardian:*

Date*

Navigation

Quick Link

Look Book