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 note that this IS NOT an appointment confirmation, nor confirmation that you are considered an active client at our hospital.

Our team will reach out to you to schedule your pet’s visit.

Owner Information

Owner's Name *

First

Last

Primary Phone Number *

Secondary Phone Number

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email *

Spouse / Co-owner's Name

First

Last

Co-owner's Phone Number

Pet Information

Name of your pet *

Breed *

Colour *

Date of Birth / Age *

Sex *

Last Vaccinations *

Name of previous veterinary practice *

Why are you booking this appointment? *

What is your preferred appointment date? *

How were you referred to our practice? *

Who recommended our practice to you? We'd like to thank them!

We occasionally post patient photos on our social media sites. Only the pet's name and photo will appear. Do we have your permission to take and use photos of your pet on our social media sites?

By clicking yes, I agree to be held financially responsible for all pets in this file and to pay all fees, including services authorized by the individuals listed above. All fees are due at the time services are rendered. I understand that any medical or surgical procedure carries some risk and that it is not possible to guarantee a successful outcome of any procedure. This agreement will remain in effect indefinitely from this date, unless I notify McLean Animal Hospital in writing, requesting to cancel the agreement. *

Yes

New Client Registration

Owner Information

Pet Information

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McLean Animal Hospital

Contact

Address

Hours of Operation

After Hours Emergencies