New Client Forms

Call Us Today! (707) 546-4646

New Client Form

Thank you for giving us the opportunity to care for your pet(s). Our computer needs to know your pets’ vaccination history in order to send you reminder cards at the appropriate time. In addition, we would appreciate it if you would allow us to get to know you better by giving us the following information.

Your Name*

Address*

City, State & Postal Code:

Phone Number*

Alternate Phone #

Spouse or Partner Name

Place of Employment

Work Phone #

Best time and place to reach you:*

Your Email*

How did you hear about us?*

May we publish photos we take of you/your pet on our website/social media?*
YesNo

Creating a Fear Free experience is important to us:

Are there any treatments or services that increase the fear, anxiety, or stress level of your pet?

Does your pet have any favorite treats, foods, or toys?

What are the names of any previous vet clinics or hospitals that we can contact to get a copy of your pet’s records?

Submitted By*

Please prove you are human by selecting the Cup.

 

Fear Free Pre-Visit Client Questionnaire

As a Fear Free Certified Professional team, we want to make your pet’s veterinary experience as enjoyable and as stress free as possible. As such, it’s important for us to understand what your pet might find upsetting. The information will help us to adjust our care to better serve and comfort your pet. Please answer the following questions to the best of your ability so we can take into consideration both your & your pet’s preferences.

Your Name*

Your Email*

How would you describe your pet’s reaction to going to the veterinary hospital?*
Eager and excitedSubduedReluctantSomewhere in between

Check any situation listed below that your pet has shown avoidance or dislike of in the past. You can add additional comments at the end.*

Comments:

How and where does your pet travel in the car? (carrier, seatbelt, loose, etc.)*

How does your pet behave in the car?*

Does your pet show any signs of nausea with car travel, such as drooling or vomiting?*

How would you describe your pet around other animals and people?*

Does your pet have any sensitive areas that he does not like to have touched or examined by you or others?*

Are there any procedures your pet has not liked having performed at the veterinary hospital in the past or that seemed difficult for you or the staff to do? (nail trims, weight, temperature, ear exam, blood draw) If so, how did your pet react?*

What are your pet’s favorite treats? (Please bring some to your next visit to our hospital)*

Does your pet like to play with toys? If so what kinds?*

Has your pet ever been prescribed any medications to help with a visit to the veterinary hospital? If so, please list below:*

Anything else you would like us to know?*

Please prove you are human by selecting the Tree.

/* */