New Patient-Continuation Registration Form **PLEASE NOTE THAT THIS FORM SHOULD ONLY BE COMPLETED IF YOU ARE AN ESTABLISHED CLIENT AND YOU HAVE A NEW PET COMING TO SEE US OR IF YOU ARE A NEW CLIENT THAT IS REGISTERING MULTIPLE PETS.**First Name*Last Name*Pet Name.*Breed*Sex*MaleMale NeuteredFemaleFemale NeuteredColor*Birthday or Age*Lifestyle*Indoor SolitaryIndoor SocialIndoor/OutdoorOutdoor OnlyDo you have proof of vaccines and/or medical records?If your pet has previously been seen at another veterinary facility please have the records faxed to 210-697-8337What is the name of your previous vet. And what is their phone number (in case we need to call to get records).Reason for visit?*Pet's food is*Pet's current medication(s)? (Type NONE if not applicable)*Do you authorize Babcock Hills to release your pet's medical records to any other veterinary facility (clinic, shelter groomer, breeder, or boarding facility)?*Please list any major medical diagnosis or conditions your pet has: (Type NONE if not applicable)*I hereby authorize the veterinarian to examine, prescribe for, and/or treat the above-described pet. I assume responsibility for all charges incurred in the care of this animal. I also understand that all charges must be paid at the time services are rendered and that a deposit may be required for any surgical, hospitalization treatment, or extended boarding. Digital Signature*Date* Date Format: MM slash DD slash YYYY PhoneThis field is for validation purposes and should be left unchanged.
