New Patient Form

In order to provide your pet with the quality veterinary service they deserve we will need a little information about your animal before we get started. Please fill out our New Patient Form using one of the options below if your pet is a new patient at American Pet Hospital.

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Option 1

Complete Online

Complete and submit the online form below.

Option 2

Print & Complete

Bring the completed form with you to our hospital.

Download Form

Option 3

Complete on Arrival

If you prefer, fill out the form when you get to our hospital.

New Patient Form

Owner Information

Emergency Contact

Patient Information

Primary Veterinarian Information

By listing your primary care veterinarian above, you are authorizing American Pet Hospital to release patient information to the primary care hospital or
veterinarian.
By submitting this form, I hereby authorize American Pet Hospital to render medical care for my pet(s) as deemed necessary by the veterinarian. I understand that no guarantee can be given to the outcome of treatments and take it as my responsibility to comprehend any risks involved. I agree to pay for the cost of all services to which I consent to by written or verbal estimate. I understand that a deposit is required before diagnostics and treatments can be initiated and that payment in full is required prior to discharge of patient from American Pet Hospital.

New Patients Are Always Welcome.

Looking for quality veterinary care delivered with a friendly smile? Contact us today to book an appointment for your pet!

Contact Us

(209) 549-8387