New Clients - Cambridge Post Oak Animal Clinic

Welcome!

Thank you for choosing us! Below you will find our new client information form. Please fill it out before your appointment so we can minimize the amount of time you spend waiting in your car. Thank you for being understanding! Remember to give us a call from your car as soon as you arrive in the parking lot so one of our vet techs can take care of you and your pet.

New Client Form

Date and Time of your appointment*
Only fill this form if you already have an appointment set up with us. If you need to set up an appointment give us a call or fill out the "Contact Us" Form
Name*
First Last
Spouse Name
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Cell Phone*
What is the best number to reach you?
Home Phone
Spouse Phone
Email*
Additional Contact
Name, Phone Number and Relation
Animal History*
Name
Species*
Is your pet male or female?*
Has your pet been spayed/neutered?*
Age or Date of Birth*
How old is your pet?
Breed
Color
Is your pet current on all vaccines?
Please bring a copy of your pet's vaccine records to your appointment if they have been vaccinated previously.
Is your pet fearful or aggressive?*
Does your pet need a muzzle to be examined?
Bringing more than one pet?
Please list the name, age, and description for each additional pet.
Release of Medical Records*
I hereby request and authorize Cambridge-Post Oak Veterinary Clinic, to release the requested medical information for my pet(s) including vaccination history and/or complete medical records. I release Cambridge-Post Oak Veterinary Clinic’s veterinarians and staff from any and all legal liability for the release of information to the extent indicated and authorized herein. I may revoke this authorization in writing at any time.
What is the reason for your visit?
Please list any problems or concerns.
Preferred method of communication*
- Select All
- Email
- Text
- Call
- Postcard
Comments
This field is for validation purposes and should be left unchanged.