Name *

First

Last

Email *

Primary Phone *

Secondary Phone

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Who else is authorized to make decisions about your pet's healthcare? *

First

Last

Phone

How did you find out about our hospital? If you were referred by someone, who should we thank? *

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Yes
No

What is the microchip number?

Do you have a second pet? *

Yes
No

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Yes
No

What is the microchip number?

Do you have a third pet? *

Yes
No

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Yes
No

What is the microchip number?

Do you have a fourth pet? *

Yes
No

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Yes
No

What is the microchip number?

Do you have a fifth pet? *

Yes
No

Pet's Name *

Species (dog, cat, etc.) *

Breed (copy) *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Yes
No

What is the microchip number?

Previous Medical Records

Click or drag files to this area to upload. You can upload up to 3 files.

Payment is due in full at the time that services are performed. If being admitted into the hospital, we cannot begin the care of your Pet until you have confirmed your desire to do so by 1) signing the client consent & estimate form, and 2) leaving an initial deposit of 50% of the upper end of the estimate. This is the only way that we have of knowing for certain that you want us to proceed with the care of your Pet. We accept Cash, Visa, MasterCard, Discover, and CareCredit payments. We neither extend credit, nor bill for services. All open invoices are sent to collections after 45 days unless prior arrangements are made. *

I have read and accept the financial policy.

By checking one of the options below, you consent to the use of photos, videos, or other content featuring you and/or your pet on our social media platforms, website, and promotional materials. These may include, but are not limited to, educational posts, success stories, and marketing campaigns. We respect your privacy, and no personal identifying information (e.g., full name, address) will be shared without your explicit permission. If you wish to withdraw your consent at any time, please contact us, and we will promptly remove the content. *

I agree to the terms outlined above and grant permission for my content to be used as described.
I do NOT agree to the terms outlined above, please don't use my content for anything described.

By checking one of the options below, you can indicate whether you consent to the audio and/or video recording of your veterinary appointment. Recordings are used internally for documentation, training, or quality assurance purposes to ensure the highest level of care for your pet. We respect your privacy, and no recordings will be shared externally or used for marketing purposes without explicit permission. If you have any questions or concerns about this policy, please contact us prior to your appointment. *

I agree to the terms outlined above and grant permission for my veterinary appointment to be recorded.
I do NOT agree to have my veterinary appointment recorded.

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New Client Form

We Proudly Serve the Pets of Denver, CO, and Beyond.

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