NEW CLIENT APPLICATION

nEW CLIENT APPLICATION FORM

We are once again accepting new clients and patients! If you would like to be considered for an appointment please fill out the form below and we will be in touch within a week.
Please note we are a privately owned Veterinary Hospital that strives to provide high quality medicine for our patients and our relationships with our patients and clients are very important to us. Due to high demand and our dedication to our current clients we are unable to provide emergency care to patients we have not seen before.

client information (required)

* Indicates required field

Client Name *

First

Last

Phone Number *

Email Address *

Do you currently have a local Veterinarian? *

Yes No

If yes - Why do you want to change Veterinarians? *

What is the name of your previous Veterinary Clinic? *

PATIENT 1 INFORMATION (required)

Patient 1 Name *

Species *

Breed *

Age or Birth Date *

Is your pet spayed or neutered *

Yes No

Please list current medications and preventives your pet is currently on *

Please list any current health conditions that require management *

When was your pets last visit to the Veterinarian? *

When is your pets next Annual or Geriatric Examination due? *

IF you have more than one pet please provide the same information for each below:

Patient 2 Information *

Patient 3 Information *

Submit

City View Animal Hospital
1445 Merivale Road
Unit # 102
Ottawa, ON
K2E 5N9

Phone Number: 613-727-6696
Fax Number: 613-727-6680
Email: [email protected]

Directions

Hours Of Operation
Monday 9am-6pm
Tuesday 9am-7pm
Wednesday 9am-7pm
Thursday 9am-7pm
Friday 9am-6pm
Saturday Closed
Sunday Closed

Request An Appointment

FOR CURRENT CLIENTS ONLY
New Clients Please Fill Out The Client Application Form

In Case Of Emergency Outside of Business Hours Please Call:

Ottawa Animal Emergency and Specialty Hospital
Alta Vista Animal Hospital
Ottawa Veterinary Hospital
Capital City Specialty & Emergency Animal Hospital

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