New Client Form New client appointments are currently being scheduled 3 weeks in advance. Please complete the following form to request an appointment. Please also note that availability will vary depending on your request. Your appointment will be confirmed by phone by a member of our staff. Please note that same day and next day appointments are often unavailable, and will incur an emergency fee. For more urgent cases, please call or text at (706) 577-4365. Thank you! Name*Phone*Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Is there a barn address different from the home address? Yes No Barn Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Preferred Contact Method*TextPhoneEmailList 3 preferred dates: *Please be aware that same day or next day appointments are often unavailable, and will incur an emergency fee.* *Appointments are only scheduled Monday - Friday.*Preferred Date 1* MM slash DD slash YYYY Preferred Date 2* MM slash DD slash YYYY Preferred Date 3* MM slash DD slash YYYY Preferred TimeMorningAfternoonPet NamePet SpeciesEquineCanineFelineCaprinePorcineOvinePet BreedDate of Birth* MM slash DD slash YYYY Pet Gender*MaleMale CastratedFemaleFemale SpayedColorEstimated WeightDo you have other pets that need to be seen? Yes No Additional PetsNameSpeciesBreedD.O.BGenderSpayed/Neutered? (Yes/No)ColorEst. Weight Reason for Visit: (Examples include vaccines, lameness, possible ear infection, skin problem, etc.)Please briefly describe any serious illnesses or surgeries your pet has had:Has your pet had any allergic reactions to vaccines or medications? Yes No If yes, please briefly describe.*Is your pet currently on any medications? Yes No If yes, please list.*Are you in need of any medication refills? Yes No If yes, please specify*To help us better prepare for your appointment, which of the following best describes your pet.Friendly / Loves everyoneTimid / ShyGo slow / Use cautionProtective of owner or territoryAggressivePlease upload any documents / pictures related to your visit:Max. file size: 8 MB.Do you give consent for images and/or video of your pet(s) to be used on our website, social media pages, or other promotional materials?* Yes No How did you hear about us?GoogleFacebookFamily/FriendOtherPerson's name* Please understand that appointment times are limited. If you must cancel your appointment, we respectfully request 48 hours notice. Missed appointments, or appointments cancelled without 48 hours notice, will incur a fee equal to your trip fee.* I acknowledge this statement.CommentsThis field is for validation purposes and should be left unchanged.
