Paperwork for New Clients

Jump to the Lameness History Form

For new clients, there is essential paperwork that needs to be completed before your pet’s first appointment. Please make sure to complete both the New Client and Lameness History forms.

Please fill out the ASOC New Client Form below.

Your Name *

First

Last

Email *

Address

City

State

Zip

Phone

Cell
Work
Home

Spouse/Partner name

Phone

YOUR PET'S NAME *

Pet's approximate weight

Pet's age or DOB

Species *

Canine
Feline

Breed *

Color *

Spay/Neuter status

Male Intact
Male Neutered
Female Intact
Female Spayed

Does your pet have a history of seizures?

HAS YOUR PET HAD ANY ADVERSE REACTION TO ANESTHESIA OR MEDICATION? IF SO, PLEASE DESCRIBE.

PLEASE LIST ANY MEDICATION OR SUPPLEMENTS THAT YOUR PET IS TAKING NOW OR HAS TAKEN WITHIN THE PAST 2 WEEKS. *

REFERRING VETERINARIAN AND HOSPITAL NAME *

REGULAR VETERINARIAN AND HOSPITAL NAME (IF DIFFERENT FROM ABOVE)

HOW DID YOU HEAR ABOUT US? (CHECK ALL THAT APPLY) *

My veterinarian
Animal Medical Center of Seattle
Friend/Family member
Yelp
Google/Search engine
Facebook
Other online source
Community event
Other

If other, please specify

WE OFTEN TAKE PICTURES OF OUR HOSPITALIZED PATIENTS AND POST STORIES ON OUR WEBSITE, FACEBOOK OR INSTAGRAM. DO YOU AUTHORIZE USE OF PICTURES OF YOUR PET FOR THIS PURPOSE ONLY? *

Phone

The information will be sent directly to our team.

Lameness History Form

The Lameness History Form should be filled out before your scheduled appointment so that we have the most current information regarding your dog’s lameness and activity tolerance.

Complete the Lameness History Sheet Here

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