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New Patient Registration Form
If you are a new client, please fill out the "New Client Form" in the top right corner of your screen. Thank you!
Owner Name:
*
First
Last
Email
*
Are you an existing client with our practice?
*
No
Yes
I am registering additional pets
https://happierathomevet.com/forms/new-client-registration-form/
Phone
*
Pet Name
*
Species:
*
Dog
Cat
Small Mammal
Reptile
Rodent
Other
Please Specify Species/Breed:
*
Gender:
*
Male Intact
Male Neutered
Female Intact
Female Spayed
Unknown
Color:
*
Age or DOB:
*
Previous Vet/Hospital (if any):
*
May we contact them for previous medical history?
*
Yes
No
N/A
Is your pet currently on any medication(s) or supplement(s)?:
*
If so, please list the medication(s)/supplement(s) and the frequency they are getting it:
*
What type of food does your pet eat?
*
(Please list the brand(s) and amount)
Any allergies or adverse reactions to medications?:
*
(If yes, please describe below)
Are there any current or past medical conditions of which we should be aware?
*
(If yes, please describe below)
Fear Free Questions
We want to make your pet's veterinary experience as enjoyable and as stress-free as possible.
Check any situations listed below that your pet has shown avoidance or dislike of in the past.
*
(You can add additional comments at the end)
Select All
Getting in their carrier or the car
Entering the veterinary hospital
Being approached by veterinary staff
Having direct eye contact with veterinary staff
Getting on the scale for a weight
Being put on the table for examination
Loud voices during examination
Having a rectal temperature taken
The use of instruments (i.e. stethoscope, otoscope, ophthalmoscope, etc.)
None of the above
How would you describe your pet around other animals and people?:
*
Does your pet have any sensitive areas that s/he does not like to have touched 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?
*
Has your pet ever been prescribed any supplements or medications to help with a visit to the veterinary hospital? If so, what was it and what sort of results did your experience?
*
What are your pet’s favorite treats? (Please bring some to your next visit with us):
*
Does your pet like to play with toys? If so, what kinds?
*
Is there anything else you would like us to know about your pet?
*
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Home
About Us
Our Team
Services
Wellness and Vaccinations
Preventive Services
Medical Services
Surgical Services
Anesthesia and Patient Monitoring
Exotic Pet Medicine and Surgery
End of Life Services
Pet Health
How-To Videos
Pet Food Recalls
Product Recalls
Contact Us
Online Pharmacy
facebook