New Client and Pet Form for Veterinary Visits

At Winchester Road Animal Hospital in Huntsville, AL, we welcome new clients and strive to make your first visit as smooth as possible. Completing the New Client and Pet Form in advance helps our veterinary team prepare for your appointment and provide attentive, personalized care from the start.

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Complete the New Client and Pet Form

Please fill out the New Client and Pet Form below with your contact details and your pet’s information, including medical history and current medications. Submitting this form ahead of your visit helps reduce check-in time and ensures our Huntsville team has accurate records before your appointment. If you have questions while completing the form, feel free to contact us for assistance.

Owner Name *

First

Last

Primary Phone *

Communication Preference

Text
Call

Secondary Phone

them Name: Vet/Clinic:

Communication Preference

Text
Call

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

How would you prefer to receive reminders?

Text
Email
Postcard

How did you hear about us? *

I understand that payment is due at the time services are provided, and that fee estimates are available upon request. I recognize that estimates are approximate and that final costs may vary based on my pet's needs. I acknowledge responsibility for all charges related to my pet's care. *

I have read and accept the financial policy.

Signature

Clear Signature

Today's Date *

Pet's Name *

Species (dog, cat, etc.) *

Age/Date of Birth *

Breed *

Color(s):

Sex *

Male
Neutered Male
Female
Spayed Female

Has your pet been vaccinated in the past? *

If yes, when?

Previous Vet/Clinic:

May we contact them for records?

Please list current medications (including supplements and heartworm/flea/tick): *

What is your pet's diet? (Brand, amount, treats)

Do you approve of the above pet to potentially be included in social media posts? *

I am the owner or authorized agent of the above described pet. I hereby authorize the veterinarian to examine, prescribe for, or treat the above described pet. I assume responsibility for all charges incurred in the care of this animal. *

I agree

Owner Printed Name:

Signature *

Clear Signature

Today's Date *

Comment

Request Your Pet’s Appointment

Winchester Road Animal Hospital is a full-service, AAHA-accredited veterinary hospital providing medical care for dogs and cats in Huntsville, AL, and surrounding communities throughout Madison County. From preventive wellness and diagnostics to surgery, dentistry, laser therapy, and boarding, our experienced team is here to support your pet’s health at every stage.

Request Appointment