New Clients Request an Appointment

New client appointment are booking out 2 to 3 months in advance due to the extreme high volume of pets in our area.

Please provide the information below as completely as possible. All information is strictly confidential.

CLIENT INFORMATION

* indicates a required field

PET INFORMATION

Type of Pet
Spayed / Neutered?
Are Vaccinations Current?
Do you have pets medical records?
If you answered yes, please upload your file here.
Medical records at another veterinary practice?
If you answered yes, please list the practice name and phone number so we can contact them for your records.
Reasons or conditions that prompted your visit?
Special requests or conditions?
Please list any additional pets here

REQUEST AN APPOINTMENT TIMEFRAME

Please confirm that you understand this form does not mean you have an appointment booked, but you will be called to get one set up with us in the future as close to your request as we possibly can. (We are booking out about 3 months in advance at this time)

Please Read

I understand, by indicating I agree and submitting this registration, that I am responsible for any charges incurred by my pet while in the care of the doctors at Pittsfield Veterinary Hospital and that charges are due and payable at the time of service.

Confirmation *

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