New Client Form

Owner's Information
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone Number (Home)*
Phone Number (Cell)
Email*
Enter Email Confirm Email
If personal referral, is there someone we can thank for this referral?
Co-Owner Information
Name
First Last
Phone Number (Home)
Phone Number (Cell)
Pet Information
Pet's Name*
Name
Species*
If you answered "Large Animal" above please specify
Breed*
Colour*
Age or Date of Birth*
Is your pet microchipped?*
- Yes
- No
Identification # (if known)
Sex?*
Previous Veterinary Practice?*
Name listed above will be on previous records
- Yes
- No
If no, who will be listed?

Have A Question? Need To Book An Appointment?

Connect with us and one of our team members will be happy to assist you.

Emergencies

Contact

P: 519-662-1525
E: reception@newhamburgvetclinic.com

19 Arnold Street, New Hamburg, Ontario, N3A 2C6

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Hours

Monday: 9:00am – 5:00pm
Tuesday: 9:00am – 8:00pm
Wednesday: 9:00am – 6:00pm
Thursday: 9:00am – 5:00pm
Friday: 9:00am – 5:00pm
Saturday: 9:00am – 12:00pm
Sunday: Closed

New Client Form

Owner's Information

Co-Owner Information

Pet Information

Have A Question? Need To Book An Appointment?

Connect with us and one of our team members will be happy to assist you.

Contact

Get Directions

Hours