Client Contact Information Update

Please help us know how best to get in contact with you!

Location

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Full Name *

Email*

Primary Phone Number*

Where would you like us to call you outside of today's appointment?

Secondary Phone Number

If we are unable to reach you at your Primary Phone Number, where else can we reach you?

Address*

City*

Province*

Postal Code

Is there someone else who should be authorized to make decisions for your pet?

Secondary Contact's Phone Number

What is their relation to you?

How do you like to be contacted for non-emergent reasons? (e.g. reminders for vaccines, medications and appointments)*

Phone Call
Text Message
Email

When is the best time to contact you?*

Do you have a preference for which Doctor your pet is examined by?

*Please note that if your pet is coming for an emergent reason we may NOT be able to facilitate your Doctor of choice

Any additional comments?

Please list any questions/problems/concerns that you would like addressed

Security Question

I HAVE READ AND UNDERSTOOD THE PRIVACY POLICY *

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