New Client Form - Sunriver Veterinary Clinic

Thank you for choosing Sunriver Veterinary Clinic as your pet’s trusted health care provider. So that we may become better acquainted, please complete the following New Client Form below prior to your pet’s first visit. If you have not yet scheduled an appointment, please contact us at 541-593-8128.

You may complete the web form and submit it online below or click the button to download the form and submit via email, ahead of your pet’s appointment.

How to download and email the PDF form:

Open the fillable PDF version of the form by clicking the button below.
Download the blank form to your computer.
Complete the fillable PDF form using your computer’s PDF reader program.
Save the completed form as a new file and email it as an attachment to info@sunrivervet.com.

If you have any questions or issues with the form, please call us at 541-593-8128.

DOWNLOAD NEW CLIENT FORM

Client Information
Owner's Name
First Last
Date
MM slash DD slash YYYY
Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Emergency Contact Phone
Whom may we thank for referring you?
Patient Information
Pet's Name
Species
Breed
Color
Age/Birth date
Gender
Spayed/Neutered
Vaccine History
Major surgeries or medical illnesses
Current medications (including vitamins and supplements)
Current diet (including treats)
AT YOUR REQUEST WE WILL GLADLY DISCUSS COST OF SERVICES AND/OR PREPARE. A WRITTEN ESTIMATE FOR RECOMMENDED PROCEDURES. PROFESSIONAL FEES ARE DUE AT THE TIME SERVICES ARE RENDERED.
Signature
Date
MM slash DD slash YYYY
CAPTCHA

How to download and email the PDF form:

Client Information

Patient Information