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New Client Registration Form

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New Client Registration Form

Thank you for considering our 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.

Please complete this form as fully as possible prior to your first appointment which will help expedite the registration process and give us valuable insight in providing optimal care for your pet(s). The required sections have a red * asterisk.

  • Owner's Name

  • Spouse/Other

  • Address

  • Pet Information

  • Privacy Consent

    At Baker Animal Clinic we respect your right to privacy. The information we seek from you is obtained so that we can provide a high quality of veterinary service and ensure that you are fully aware of your action with regards to your pets. We will not collect or disclose any personal information regarding you or your pet for the purpose of external marketing by the clinic or outside companies. We are required by the Veterinarian Act, and by law, to release pertinent information concerning your pet to the Department of Health, if requested. Having read the above paragraph, I give my permission allowing Baker Animal Clinic to keep and maintain our/my information.