New Client Form

Our New Client Form

Save time during your upcoming appointment! Before your appointment, fill out the necessary documents online at any time from any device.

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New Client Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit.

Name *

First

Last

Email *

Primary Phone *

Secondary Phone

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Pet's Name *

Sex *

Male
Neutered Male
Female
Spayed Female

Species *

What breed is your pet? *

What is your pet's date of birth? *

What are you currently feeding your pet? *

What current flea treatment is your pet on? *

What current worming is your pet on? *

What heartworm prevent ion is your pet on? *

When was your pets last vaccination? *

Any other concerns you are worried about?

What is the name of the previous Vet Clinics your pet has at tended? *

Do you have Pet Insurance?

If yes, what is the Insurance Company Name and Policy Number

As a Fear Free Cert ifi ed team, we want to mak e you pet 's veterinary experience as enjoyable and as stress free as possible. As such, it is important for us to understand what your pet might fi nd upset t ing. The informat ion will help us to adjust our care to bet ter serve and comfort your pet .

Does your pet show any reluctance get t ing in the carrier or car? *

How and where does your pet travel in the car? *

Carrier, seatbelt, loose, etc

During travel to the veterinary hospital, does your pet do any of the following: *

Eager and Excited
Reluctant Hide
Drool
Vomit
Urine/BM
Subdued
Bark/Meow
Whine
Pant
Tremble
Pace

Does your pet prefer: *

Female Veterinarian
Male Veterinarian
It doesn't matter

Tick any situat ions listed below that your pet has shown avoidance or dislike of in the past :

Getting in their carrier or the car
Entering the veterinary hospital
Other pets and/or people passing by while in reception
Waiting with other people and animals in the waiting area
Being approached by veterinary staff
Getting on the scale for a weight
Hearing the doorbell, overhead intercom, or phones ringing
Sounds coming from the back areas of the practice
Going into the exam room
Being put up on the table for examination
Being taken out of the exam room for procedures
Loud voices during examination
Having a rectal temperature taken
Having direct eye contact with the veterinarian
The use of instruments such as the stethoscope or otoscope (to look in the ears)

How would you describe your pet around other animals and people? *

Does your pet like to play with toys? if so, what kind? *

Does your pet have any sensit ive areas that he/she does not like to have touched by you or others? *

Are there any procedures your pet has not liked having performed at the veterinary hospital in the past or that seemed difficult for you or the staff to do? If so, how did your pet react? *

E.G: Nail trims, weight, temperature, ear exam, blood draw

What are your pet 's favourite treats? *

Bring some to your next visit

Has your pet ever been prescribed any supplements or medicat ions to help with a visit to the veterinary hospt ial? If so, what was it and what sort of results did you experience? *

Is there anything else you would like us to know? *

Message

We Can’t Wait To Meet You!

Your Veterinarian in Pendle Hill, NSW

We proudly serve the pets of Greystanes, Pendle Hill, Pemulwuy, Westmead, Wentworthville, South Wentworthville, and surrounding areas. We look forward to seeing you and your pet. Easily request an appointment for your pet

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Questions? Get in touch.

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Location

469 Great Western Highway, Pendle Hill, NSW 2145

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Contact Information

P: 02 9631 9322
E: info@gwah.com.au

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Hours

Mon-Fri: 8 am-7 pm
Sat: 8 am-2 pm
Sun & Public Hols: 8 am-12 pm

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