Patient Registration Form

Do you have Pet Insurance?

Yes No

If yes, please let us know what insurance:

Reason for leaving Previous Veterinarian (if any)

Date of last vaccines (if known)

What vaccines were given at this time

Is your pet on any medication or supplement?

Yes No

If Yes, please list the medication or supplement

What food does your pet eat?

Does your pet have allergies or drug reactions?

Yes No

If Yes, please list the allergies and reactions

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

Yes No

If Yes, please comment on the condition(s) and indicate if they are current or past conditions

By clicking submit, I assume responsibility for all charges incurred for the treatment and care of this animal. I also understand that these charges must be paid at the time of release and that a deposit may be required for such medical/surgical treatment.

Contact Us

Location

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Hemlock Animal Hospital

Address

1314 W 4th Avenue
Vancouver, BC V6H4A3, Canada

Contact Information 604-558-1400

1314 W 4th Avenue Vancouver, BC, Canada
604-558-1400