New Clients – Villanova Veterinary Hospital

What You'll Need To Schedule Your First Appointment

Please submit the completed form below and attach paperwork including:

Medical Records
Vaccine History
Their most recent Rabies Certificate signed by the administering veterinarian

Once received, we’ll call to scheduled your appointment and accept a deposit that covers the initial exam. Please be aware that we’re unable to schedule appointments without this form, records (unless there are none), and deposit.

Learn More about Wellness Exams & Our Services

If you would prefer to print out the New Client Information Form and fill it out yourself to bring to us, click the button below for a downloadable PDF.

Client Information Form

I am a...*
Owner*
Spouse/Partner
Address*
Street Address Address Line 2 City State ZIP Code
Phone
Cell Phone*
Email (For Reminders)*
Enter Email Confirm Email
Other person authorized to order treatment or obtain patient information
Name
Phone
Referred by (check all that apply):
- Website
- Facebook
- Internet Search
- Flyer
- Mailing
- Personal Contact
- Other Client
If Other Client, Please Specify:
Pet Information
Add Patients Below
Pet's Name
Type of Pet
If other, please specify:
Spayed or Neutered?
Breed
Color
DOB or Age
Sex
Previous Veterinarian Info
Please Attach Any Medical Records For All Patients Here:
Drop files here or
Name
Phone
- By checking this box, I authorize the veterinarian to examine, prescribe for, and/or treat the above described pet or pets. I assume responsibility for all fees incurred in their care. I understand payment is due at time of service. I also understand there is a $35 charge for any missed appointment without 24 hours’ advance cancellation.
- I give permission to post above listed pet’s photographs/videos on Villanova Veterinary Hospital’s social media and/or website.

What You'll Need To Schedule Your First Appointment

Other person authorized to order treatment or obtain patient information

Pet Information

Previous Veterinarian Info