Fraser Valley Animal Hospital

2633 Ware Street
Abbotsford, BC V2S 3E2

(604)854-2313

fvah.ca

New Client Form


Thank you for giving us the opportunity to care for your pet.  To insure the best care possible, please take time to fill in this form completely.  Thank You!

Also by submitting this form you are giving us permission to send you emails. You may opt out at any time by contacting our office.

If you would like to make an appointment please submit this form.

New Client

Name (required)
First Name (required)
Last Name (required)
Address (required)
Street Address (required)
City (required)
,
State / Province (required)
Zip / Postal Code (required)
Daytime Phone (required)
Phone TypePhone Number (required)
Evening Phone (required)
Phone TypePhone Number (required)
E-Mail Address (required) :
Pet's Name (required)

Age: Years, Months

Type of Pet (required) :
Breed: (required)

Color: (required)

Sex: (required)

Male
Female


Neutered/Spayed

Neutered
Spayed


Are your pets vaccines current?
Do you have pets medical records?
Medical records at another veterinary Practice?

Yes
No


Name of Former Veterinary Practice

May we request a transfer of records?

Yes
No


May we use your pets photo on social media platforms? (required)
Yes
No
Date of Appointment Booked? (required)

Reasons or conditions that prompted your visit?

Special requests or conditions?

Please list any additional pets here


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