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Thank You

New Client Registration Form

Thank you for considering Snelgrove Veterinary as your pet’s provider of veterinary services.

Please complete this form before your first appointment which will help expedite the registration process and give us valuable insight in providing optimal care for your pets.

Note: Please be aware that we are currently not accepting NEW Clients -please only use this form if we have seen pets of yours in the past.

Pet Parent's First and Last name:*

Address:*

City:*

Province:

Postal Code:*

Home phone:

Cell phone:*

Work phone:

Email:

Spouse/Partner:*

Name:*

Phone:*

Please use this area to give us any other relevant information (about yourself, your family or pet) that can allow us to better serve you and your pet:

Pet's Name:*

Dog

Cat

Breed (if known):

Colour:

Date of Birth or Age:*

Microchip #:

Male

Neutered

Female

Spayed

Previous vaccines:*

Is there another veterinary hospital for us to request records from?

Yes

If yes then please state the details:

Are there any medical conditions we should be aware of?

Yes

If yes then please state the details:

What type of food are you currently feeding?

Is your pet currently on any medications or supplements?

Does your pet have any allergies or have had any reactions to vaccines or medications?

Does your pet have medical insurance?

Yes

If so, please provide us with the company and policy number:

GENERAL INFORMATION

Snelgrove Veterinary Services
11526 Hurontario St
Brampton, ON

L7A 1E6

Phone: 905-846-3316

Email: contact@snelgrovevet.com

Fax: 1-855-351-8216

Hours

Monday – Friday: 8:00 AM — 7:00 PM

Saturday: Closed

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