Animal Tales Veterinary Clinic

3302 S Belt Hwy
SAINT JOSEPH, MO 64503

(816)676-1111

www.atvetclinic.com

New Client Welcome Form

If you would like to make an appointment, you can assist us to expedite your check in by submitting this form.

Thank you for your cooperation in letting us assist you.

Owner Name (required)

First Name (required)	Last Name (required)

Phone (required)
Phone Type	Phone Number (required)

Yes, send me SMS appointment reminders and communications from Animal Tales Veterinary Clinic.

E-Mail Address :

* Note that reminders are only sent by email and/or text message.

Spouse/Other Name

First Name	Last Name

Spouse/Other Phone
Phone Type	Phone Number

Emergency Contact

First Name	Last Name

Emergency Contact Phone
Phone Type	Phone Number

Pet Information

Pet's Name (required)

Date of Birth (or estimate) (required)

Type of Pet (required) :

Breed: (required)

Sex: (required)

Male
Female
Unknown

Neutered/Spayed (required)

Neutered
Spayed
Intacted
Unknown

Color:

Yes, this pet's vaccines are current.

Current medications?

Current diet?

Please list any additional pets here

Animal Tales is a pay at the time-of-service clinic.

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