New Clients

Client Information

This section is all about you.

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Daytime Phone*

Email*

Pet Information

This section is all about your pet.

Pet's Name*

Age*

If you don't know the exact age of your pet, simply estimate.

Type*

Breed*

Gender*

Male
Female

Neutered/Spayed*

Neutered
Spayed
Unaltered

Vaccines*

Are your pet's vaccines current?

Yes
No

Medical Records*

Do you have medical records on this pet?

Yes
No

Other Veterinary Practices*

Do you have medical records from another veterinary practice?

Former Veterinary Practice

What is the name of the veterinary practice you used?

Record(s) Transfer

May we request a transfer of records?

Yes
No

Reason or conditions that prompted you to contact us:*

Special requests or conditions:

Additional Pets

If you have any other pets, please list them here. (name, age, type, and breed)

Would you like for us to call you to set up an appointment?*

Yes, I would like for Dogwood to call me to set up an appointment.
No, I have already set up an appointment to see a vet at Dogwood.

Please Read*

I understand, by indicating I agree and submitting this registration, that I am responsible for any charges incurred by my pet while in the care of the doctors at Dogwood Veterinary Hospital and that charges are due and payable at the time of service, unless other arrangements are made in advance. Any balance that is carried over a period of 30 days will accrue a monthly finance charge of 1.5% or 18% per annum. Any balance that I leave unpaid will be forwarded to Dogwood Veterinary Hospital's collection agency, and will incur a 25% collection fee for which I am liable, in addition to monthly finance charges.

I have read this statement and

I agree

Welcome! We’re thrilled you’ve decided to make Dogwood Veterinary Hospital a part of your family.

As a new client, you may expedite your check-in by completing the form below. Once your application has been processed, a member of our team will be in contact with you.

NEW CLIENT EXPEDITED CHECK-IN

Client Information

Pet Information