New Client Form

Please fill out the form below, and a member of our team will get back to you as soon as possible if we have any questions. All fields marked with * are required.

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Date *

Owner *

First

Last

Spouse or Partner

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Home Phone

Cell Phone

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

Yes
No

Work Phone

Email *

Place of Employment

How did you hear about us? *

PAYMENT IS DUE UPON RELEASE OF PATIENT. WE ACCEPT CASH, PERSONAL CHECKS, DEBIT, AND BANKCARDS (VISA/ MASTERCARD/ DISCOVER). *

Initial

Pet's Name *

Breed

Color

DOB (Date of Birth)

Sex

Male
Female

Has your pet been spayed or neutured?

Yes
No

History

New Client Registration

New Client Form

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Caring for Pets for More Than 90 Years!

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Address

Contact Info

Hours

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