New Client Form

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

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New Client Form

We know how important your pet’s heath is to you, and we thank you for trusting us to care for them. To help us provide the best care possible, please take a few moments to fill out this form completely. Thank you!

You can complete and submit this form online, or you can download it by clicking the button below. Finished downloaded or printed forms can be emailed to us at tcvhosp@tcvhosp-allegan.com or brought with you to your appointment.

Download Form

Name Of Pet Owner *

First

Last

Name Of Spouse

Cell Phone # *

Alternate Phone #

Email *

Of How For

Address *

Address Line 1

Address Line 2

City

State

Zip Code

How Did You Learn About Our Clinic? *

Pet Health History

Name Of Pet *

Species *

Dog
Cat

Breed *

Color *

Birthdate/Age *

Sex *

Male Intact
Male Neutered
Female Intact
Female Spayed

Vaccine History: Where We Can Get Copies Of Your Pets Records?

Reason For Visit

Coughing/Sneezing:

How Often:

Vomiting/Diarrhea:

How Often:

Itching/Scratching:

How Often:

Does Your Pet Need Any Medication Refills?

Authorization: I hereby authorize the veterinarian to examine, prescribe for, and/or treat my pet(s). I assume full responsibility for all charges incurred for the care of all my pets on my file. I also understand that these charges will be paid at the time of release and that a deposit may be required for surgical treatment or hospitalization. I also understand and agree to a $3.50 billing charge and responsibility for any collection charges for a balance due for any reason.

Signature *

Clear Signature

Date *

Important Notice

As part of our commitment to the safety and well-being of all pets in our care, we kindly remind you to please ensure that your furry friends are securely restrained when visiting our veterinary clinic. Why is this so crucial? Not only does it help prevent accidents and injuries within our premises, but it also ensures the safety of your beloved companions and others. A securely restrained pet reduces the risk of them getting startled or anxious, which can lead to unpredictable behavior and potential harm to themselves or others. By keeping your pets safely secured with leashes, carriers, or other appropriate restraints, you help create a calm and controlled environment for everyone during their visit. Your cooperation in following this protocol is greatly appreciated and contributes to a positive experience for both you and your pets.

Thank you for entrusting us with the care of your cherished companions. Together, we can ensure a safe and enjoyable experience for all.

New Client Form

New Client Form

Pet Health History

Important Notice

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Contact Info

Location

Hours