New Patient Registration Form

Please complete this form with your and your pet's basic information so that we may effectively and efficiently provide the service you deserve!

*We use a communication software called PetDesk to manage client communications, send you reminders about upcoming appointments and to send you offers about our products and services. You agree that we may share your name, pet's name, email address, address and phone number with PetDesk to facilitate this process. You will receive a welcome email within 24 hours. You may elect to OPT out of any reminder services at that time.
Pet Information:

Picture Release: I understand and approve that Anderson Lakes Animal Hospital may take pictures during the course of my visit for use on their website and/or social media.
Anderson Lakes Animal Hospital may use pictures of clients/patients for promotional and publicity purposes without liability or obligations to the participants.


 

By checking the boxes below, I agree that I have read and acknowledged each statement as it is written.
By signing below I agree to the above terms and conditions.