New Patient Information Form

We are excited to meet you and your pet(s). 

By checking this box, I acknowledge that a $74 scheduling fee is required to reserve this appointment time. This fee will be applied to the invoice at the time of the appointment. Please note this fee is non-refundable if the appointment is cancelled with less than 24 hours notice of the scheduled appointment time.
Client / Owner Information
About Your First Pet
Pet Records
Please note that we require submission of your pet's records prior to your visit. This allows our veterinary team to thoroughly review your pet’s history in advance, ensuring the highest level of care during your appointment.
One file only.
100 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.
I authorize Briar Patch Veterinary Hospital to contact my previous veterinarian to obtain medical records prior to my appointment. 
I hereby authorize the veterinarian to examine, prescribe for, or treat the above-described pet(s). I assume responsibility for all charges incurred in the care of this animal. I also understand that these charges must be paid in full at the time of the pet's release.
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