Client Name *

First

Last

Primary Phone Number *

Email *

Secondary Contact *

First

Last

Secondary Phone Number *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Previous Veterinary Records

Do you have your pet’s medical history? *

Yes, I have my pet's medical history.
No, my pet has never been to a vet before.
No, I do not have my pet’s medical history.

Name of Clinic

Phone Number

Address of Clinic

Address Line 1

Address Line 2

City

State

Zip Code

Would you like to add another veterinary clinic?

Yes
No

Name of Clinic

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Would you like to add another veterinary clinic?

Yes
No

Clinic Name

Phone Number

Address

Address Line 1

Address Line 2

City

State

Zip Code

Please upload any medical history docments: *

Click or drag files to this area to upload. You can upload up to 8 files.

Pet Information

Pet's Name *

Age *

Species *

Intact/Neutered *

Breed *

Color *

Any medical allergies? *

History of vaccine reactions *

Current medications/treatments *

Microchipped *

Y
N

Reason for Visit *

Does your pet show any reluctance to getting in the carrier or car? *

Yes
No

How would you describe your pet's behavior during travel? (select all that apply) *

Eager & excited
Subdued/more quiet than usual
More vocal than usual

Does your pet do any of the following during travel? (select all that apply) *

Are there any situations that your pet has tried to avoid or seemed to dislike in the past? (select all that apply) *

If you chose other, please explain: *

Has your pet ever been prescribed any medications to help manage their fear or anxiety associated with the visit? *

Yes
No

If so, what was the medication and dose, and what sort of results did you experience? *

In order to stay committed to helping pets when they need it, we collect a $95.00 non-refundable deposit while you’re scheduling your first appointment with us. This is the cost of our new patient exam fee and the deposit will go towards your first visit with us. We have a 24 hour cancellation policy for any scheduled appointments with us, which helps us ensure that we’re able to meet the needs of patients in our care. We are closed over the weekend so if you need to cancel an appointment for Monday, please give us a call and leave us a voicemail so we know as soon as possible. *

I have read and understand

New Client Form

New Client Form

Previous Veterinary Records

Pet Information

Book An Appointment

Questions?

Location

Contact Information

Hours

Locations We Serve

Portland, OR

Beaverton, OR

Tigard, OR

Tualatin, OR

Wilsonville, OR

Lake Grove, OR

Durham, OR

Stafford, OR