New Clients Request an Appointment

Current new client appointment are booking out 4-6 weeks in advance.

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?
Medical records at another veterinary practice?
Would you like us to call you for your appointment
Reasons or conditions that prompted your visit?
Special requests or conditions?
Please list any additional pets here

REQUEST AN APPOINTMENT

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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