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
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Day-Time Phone*
Evening Phone
Mobile Phone
Email*
Enter Email Confirm Email
Co-owner's Name & Contact #
Name
First Last
Phone
How did you find out about our practice?
- Clinic Location
- Personal Referral
- Internet Search / Website
- Yellow Pages
- Clinic Sign
- Newspaper / Print Media
- Other
If Other, please specify:
If Personal Referral, is there someone we can thank for this referral?
Please use this area to give us any other relevant information about yourself or your family
Pet Information
Pet's Name*
Species*
or if other species
Breed (if known)
Color
Date of Birth or Age (if known)
Special Identification (tattoo, microchip, etc.)
Sex
Previous Veterinary Practice (if any)
Do we have permission to contact the previous veterinary practice?
- Yes
- No

We're here to help.

Contact us, we’re happy to assist you.

ADDRESS-
1662 Valleyview Dr.
Kamloops, BC V2C 4B5
PH: 250-374-5649
E: reception@valleyviewvet.ca

HOURS-
Monday to Friday: 8AM – 5PM
Saturday: 9AM – 4PM

*We are able to accommodate same day appointments.

SISTER CLINIC:

Chase Veterinary Clinic
614 Shuswap Ave.
Chase, BC V0E 1M0
778-765-1018

Exams, vaccinations, health concern exams
Blood testing
Microchips
Feline spay & neuter
Prescriptions
Veterinary diets
Nail trims, anal glands

ON SITE GROOMING SERVICES:

Pet Connection Pet Grooming
P: 250-372-3800
Petconnectiongrooming.ca

New Client Registration Form

Owner's Name

Co-owner's Name & Contact #

Pet Information

We're here to help.

Contact us, we’re happy to assist you.