(Existing Clients)
We cannot wait to meet and get to know the new member of your family. Congratulations! Please fill out the form below so we are prepared for your pet’s visit to our clinic. The first thing you should know is that we are a family environment here at SVVC. If you are nervous about your visit or have any questions, please let us know. During your visit, if you don’t know how to answer something or are unsure of what something means, we are he to help! If your pet is overdue for vaccines, we understand life happens; you’re here now! Concerned about costs? No problem, we will provide you with an estimate before you spend any money and then every step of the way. To help us prepare for your pet’s appointment appropriately please let us know in advance of your pet’s appointment if they are nervous/aggressive or anxious at the vet, it is new place for them and we understand that each pet deserves a visit catered their individual needs!

Pet Information

Name of New Pet

Pet Type (dog/cat)

DOB

Color

Breed:

Microchip #

Sex

Female
Female Spayed
Male
Male Neutered

Your pet is a (Mark all that apply)

Insurance Company/Policy Number

Insurance Includes

Accident/Illness only
Wellness Care/Accident+Illness

Date you adopted your pet

From where did you acquire your pet

Breeder (Name)
Shelter (Name)
Private Adoption

Breeder (Name)

Shelter (Name)

Your pet’s current medications (Including flea/tick/heartworm preventatives)

Your pet’s current medications (including flea/tick/heartworm preventatives):

Name

Dose and Directions

Dose and Frequency Administered

Date Started

Please fill out the record information below to help us acquire records or contact appropriate parties if needed, prior to your pet's first visit.

Do you have medical records for your pet

Yes (if so, please email to scottsvalleyvet@gmail.com)
No

If you do not have any records is there somewhere or someone we can contact for you?

Does your pet have any special medical conditions, illnesses or allergies

Your pet’s favorite treat

Does your pet have any dietery restrictions or special treats (if yes please bring some of those special treats with you, we have treats for dogs with food allergies but we want them to have the their favorite)

Has your pet had any previous surgeries

Do you expect your pet will be nervous when visiting our clinic for any reason

Any other concerns for your pet’s first visit

Client Full Name

Phone Number

Email

Date

Signature

Clear Signature