We are pleased to provide you with online forms for your convenience.
New Clients: Please fill out both the New Client Form and a New Pet Form for each one of your pets.
Owner’s First Name *
Owner’s Last Name *
Co-Owner’s First Name *
Co-Owner’s Last Name *
How did you hear about us? *
Would you like us to call you for your appointment? Please Select an AnswerYesNo
Do you have records of your pets’ medical records? Please select an answerYesNo
Name of former veterinary practice?
Reasons that prompted your visit?
Special requests or conditions?
Please list the names of all person(s) who have permission to authorize treatment for your pets
Please list your pets here and then fill out a "New Pet Form" below for each.
0 + 7 = ? Please prove that you are human by solving the equation *
Owner’s Name *
Pet’s Name *
Type of Pet * Please select an asnwerCanineFelineFerretRabbitRatGuinea PigHamsterChinchillaMouseOther
Date of Birth *
Sex * Please select an answerMaleFemale
Are Your Pet’s Vaccines up to date? * Please select an answerYesNo
Does your cat go outside? *
Is your cat/dog on heartworm preventitive? * Please select an answerYesNo
Is your cat/dog on flea/tick preventitive? * Please select an answerYesNo
Your pet is: Please select an answerA member of our familyA child’s petA backyard pet
What brand & formula of food do you feed your pet? *
Do you brush you pet’s teeth? Please select an answerYesNo
If so how often? Please select an answerYesNo
Date of last dental cleaning?
Please list any medications, illnesses, previous surgeries, allergies, or any specific concerns:
5 + 1 = ? Please prove that you are human by solving the equation *
1 + 3 = ? Please prove that you are human by solving the equation *
199 Route 101, Building 8
Amherst, NH 03031
Phone: (603) 673-5300
Fax: (603) 673-5353
Mon & Wed: 8am – 7pm
Tues, Thurs, Fri: 8am – 6pm
Saturday: 8am – 1pm