New Client Form

Duluth Veterinary Hospital New Client Form

Before filling out this form, please be aware of the following:

Give us up to 7 business days to respond to your appointment request.

We are currently scheduling about two months out for appointments.

A $100 deposit will be collected when the appointment is scheduled to hold the spot, which then comes off the invoice at the time of services, and is refundable as long as a 24-hour notice is given.

New Client Form

Name

First Name

Last Name

Address

Street Address

Street Address 2

City

State/Province

Postal Code

Phone Number

Previous Veterinary Clinic

Previous Veterinary Clinic Phone Number

** All records pertaining to the patient(s) must be sent to us before an appointment is scheduled, please call your clinic to have their records sent to us. Records can be emailed to Info@duluthvet.com, if you have any questions call (218) 728-3616. Once the doctor has reviewed the information, we will reach out to the client to set up the first appointment and take a deposit for the first visit.

Patient Information

Name

Species/Breed

Age

Color

Sex

Female - intact

Female - spayed

Male - intact

Male - spayed

Medications

Any chronic conditions or illness? If so, list:

Any behavioral concerns you would like to have addressed?

Has your pet ever needed calming medication for veterinary visits, or do you think they would benefit from calming medications for visits?

Any history of fear, aggression, anxiety, or stress at a vet clinic or in other situations? If so, please describe the situation. This will help us determine how to appropriately schedule the appointment as fearful/stressed animals may require more time.

New Client Form

Duluth Veterinary Hospital New Client Form

Before filling out this form, please be aware of the following:

Name

Address

Patient Information

Our Clinic

Clinic Hours