New Client Form in Spruce Pine, NC | Mitchell Veterinary Hospital

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Spouse/Co-owner*

How did you hear about our practice?*

Pet Information

Name*

Breed

Color*

Birthdate

Sex*

Male
Female
Male - Neutered
Female - Spayed

How long have you owned this pet?*

Where was your pet obtained?*

Has your pet had any previous medical problems or surgeries?*

Do you travel with your pet?*

Yes
No

If so, where?*

Reason for today’s visit*

Payment

All professional fees are due at the time services are rendered unless previous arrangements have been made. We will gladly prepare a written estimate of service fees if you desire (please ask the doctor or assistant).We accept cash, credit cards and checks with proper identification. There will be a $25.00 service charge for returned checks.

To prevent the spread of disease, all hospitalized pets are required to be current on vaccinations and free of external parasites.

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