New Client Form

Welcome to Vancouver Veterinary Hospital!

APPOINTMENT

Please complete the following form prior to your first appointment.

If you have questions, please contact us. We look forward to seeing you!

1Owner Information

2Pet Information

3Additional Information

Owner's Name*
First Last
Spouse/Co-Owner's Name
First Last
Email*
Address*
Street Address Address Line 2 City State ZIP Code
Home Phone
Cell Phone
Work Phone
Other Authorized Pet Caretaker
First Last
Relation
Phone

Pet's Name*
Species
- Cat
- Dog
Pet Breed
Pet Color
Pet Birthday/Age
Sex
- Male
- Male (Neutered)
- Female
- Female (Spayed)
Does your pet have any allergies, special medications, or health problems we should know about?
- No
- Yes
If yes, what are they?
What type of food does your pet eat?
Treats?

How did you hear of our hospital?
Whom may we thank and please explain.
We appreciate payment when services are rendered. For your convenience, we accept cash, Mastercard, Visa, Amex, and Discover. We currently do NOT accept checks.*
I have read and understand.
I verify that all the information provided is accurate.*
I have read and understand.
Owners Digital Signature*
Phone
This field is for validation purposes and should be left unchanged.

Trusted, compassionate veterinary care in Vancouver, WA!

The Vancouver Veterinary Hospital team is here to provide exceptional care for our 4-legged friends.

Location

1616 St Johns Blvd
Vancouver, WA 98661

Hours

Mon - Sat – 8:00 AM – 6:00 PM
Sun – Closed

Contact Info

Phone: (360) 696-2529
Fax: 360-696-0026
Email: vancouvervet@wellhaven.com

Request an Appointment Online!

Use our online appointment request form to request an appointment online in minutes.

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Visit Our Online Pharmacy!

Our online pharmacy enables you to refill your pet’s prescriptions and food all in one place!

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