New Client Registration

If you have any questions, feel free to contact the clinic at 613-531-3334 to speak with a member of our team.

Full Name *

Co-owner's Name

Address *

City *

Province *

Postal Code *

Phone Number *

Alternate Number

Email Address *

Do you consent to being sent emails from our clinic? *

Yes
No

Do you consent to us taking and posting pictures of your pet on social media? *

Yes
No

How did you find out about our practice?

PATIENT INFORMATION

Pet's Name *

Species *

Breed (if known)

Colour *

Date of Birth/Age *

Sex *

Identification (e.g. tattoo or microchip number)

Markings

Known Allergies *

Date your appointment is scheduled for: *

What is your primary concern today? *