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New Patient Form

We thank you for choosing our health care team. Please complete the following information to help us provide your pet with quality care.
Owner information
Name*

First

Last
Address*

Street Address

Address Line 2

City

State

ZIP Code
Email*
Alternate Email
Phone #1*
Phone #2
Phone #3
Preferred method of contact*
- Text
- Email
- Phone
- Mail
Name of husband/wife

First

Last
Referred by

First

Last
Pet information
Pet's name*
Pet type*
- Dog
- Cat
Breed*
Color*
Age or date of birth*
Pet's gender*
- Male
- Female
Is your pet spayed or neutered?*
- Yes
- No
How long have you owned this pet?*
Where does this pet sleep?*
Date of last vaccine and/or test given
Last veterinarian who provided services for your pet
Are there any previous medical problems or allergies of which we should be aware?*
- Yes
- No
Please explain*
Is your pet currently on any medications?*
- Yes
- No
What medications is your pet taking?*
What brand of pet food do you currently feed?
Do you have any other pets?*
- Yes
- No
How many?*
Due to the nature of the services rendered in this office, full payment is required when services are rendered. A substantial deposit is required on hospitalized patients when charges of $100 (one hundred dollars) or more are incurred. Please indicate below your choice of payment.
Form of payment
- Cash
- Personal check
- Visa/MasterCard/Discover
- Care Credit

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Home
Our Hospital
Urgent Care
Services
New Clients
Shop Online
Forms
Pet Portal
Contact Us

Get in touch

989-348-8622

5806 W M-72,
Grayling, MI 49738

Make an appointment

989-348-8622

5806 W M-72,
Grayling, MI 49738

Make an Appointment

Pharmacy Pet Portal

Home
Our Hospital
Urgent Care
Services
New Clients
Shop Online
Forms
Pet Portal
Contact Us

Business Hours

Monday

8:30am - 6:00pm

Tuesday

8:30am - 5:00pm

Wednesday

8:30am - 5:00pm

Thursday

8:30am - 5:00pm

Friday

8:30am - 5:00pm

Saturday

Closed

Sunday

Closed

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