Morehead City, NC

New Client Registration

Thank you for considering PetDocks Veterinary Hospital as your pet’s provider of veterinary services. We are dedicated to maintaining the health of your pet and look forward to many future years together.

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New Client Registration

Please complete this form as fully as possible before your first appointment. This will help expedite the registration process and give us valuable insight into providing optimal care for your pet(s). The required sections have a red * asterisk. If you need immediate assistance, please call us directly at 252-418-8385.

Owner's Information

Name *

First

Last

Email *

Primary Phone *

I consent to receive SMS text messages from PetDocks Veterinary Hospital. Msg & data rates may apply. Reply STOP to opt-out. *

Secondary Phone

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Co-Owner's Information

Name *

First

Last

Phone Number

Professional Fees are due at the time the service is rendered. If you wish to pay by check, please complete the following:

Driver's License

state and number

Date of Birth

How did you find out about our practice?

If Personal Referral, is there someone we can thank for this referral?

Although you are responsible for any charges accrued while your pet is here, is there anyone you give permission to drop off or pick up your pet in your place? (please be advised that the names in this section will be able to sign medical forms, estimates, legal documents, etc. They must be 18 years or older.)

Pet Information

Pet's Name *

Species (dog, cat, etc.) *

Sex *

Male
Neutered Male
Female
Spayed Female

Age/Date of Birth

Breed

Color

Does your pet have a microchip identification? *

Other Special Identification (tattoo, personalized collars, etc.)

Previous Veterinary Practice (if any)

Date of last vaccines (if known)

DUE TO STATE LAW AND INSURANCE REQUIREMENTS, ALL DOGS, CATS AND FERRETS OVER THE AGE OF 4 MONTHS OLD MUST BE CURRENT ON A RABIES VACCINATION. Do you have verification of rabies status with you? *

Yes
No
Not of Age (under 4 months old)

We must have a certificate or a report from another veterinarian's office showing rabies status. Rabies tags are not valid verification.

Is your pet on any medication or supplement?

Does your pet have allergies or drug reactions?

Are there any current or past medical conditions of which we should be aware?

Please let us know any other relevant information about your pet:

Have you already scheduled an appointment with us? If so, what is your appointment day and time?

Date

Time

Signature *

Date *

Comment

Morehead City, NC

New Client Registration

New Client Registration

Owner's Information

Co-Owner's Information

Professional Fees are due at the time the service is rendered. If you wish to pay by check, please complete the following:

Pet Information

Ready for a visit?

Get in touch

Address

Contact

Hours

After Hours Emergencies