New Client Registration Form – Bathurst Animal Hospital

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New Client Registration Form
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New Client Registration Form

Thank you for considering our hospital as your pet’s provider of veterinary services. We are dedicated to maintaining the health of your pet and look forward to many future years together.

Please complete this form as fully as possible prior to your first appointment which will help expedite the registration process and give us valuable insight in providing optimal care for your pet(s). The required sections have a red * asterisk.

Owner's Name
Name*
First Last
Address (Please also provide your apartment# if applicable)*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Mobile Phone*
Landline Phone*
Email*
Enter Email Confirm Email
Co-owner's Name & Contact #
Name
First Last
Mobile Phone*
Landline Phone*
How did you find out about our practice?
- Clinic Location / Sign
- Personal Referral
- Internet Search / Website
- Other
If Other, please specify:
If Personal Referral, is there someone we can thank for this referral?
Please use this area to give us any other relevant information about yourself or your family
Have you booked your appointment?*
- Yes
- No
If so, when is your appointment scheduled?*
Date Format: MM slash DD slash YYYY
Pet Information
Pet's Name*
Species*
or if other species
Breed (if known)
Color
Date of Birth or Age (if known)
Sex
Previous Veterinarian / Practice (if any)
Please bring your pet’s vaccination and any medical records to your first appointment
Please list any known/diagnosed allergies that your pet has
Has your pet ever experienced any ‘negative’ reaction(s) following vaccination?
- Yes
- No
If YES, please specify:
What does your pet eat? (brand)
What kind of treats do you offer your pet? (brands)
Is your pet taking any medication(s) or supplement(s)?
- Yes
- No
If YES, please specify:
Is your pet on regular flea, tick and/or heartworm prevention?
- Yes
- No
If YES, please specify:
Please use the following box to give us any other relevant information about your pet

Ready to schedule an appointment? Book Now

CONTACT INFORMATION

352 Wilson Avenue
Toronto, Ontario M3H 1S9

Phone: (416) 635-9090
Email: info@petdoctor.ca

Schedule an Appointment

Monday-Friday: 9am-5pm
Saturday: 9am-12pm
Sunday: CLOSED

HOURS OF OPERATION

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CVO ACCREDITED

“The College of Veterinarians of Ontario protects and serves the public interest through the regulation of the practice of veterinary medicine.”

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New Clients
- What to Expect
- New Client Form
About Us
MY VET STORE
Services
Pet Health
Links