New Client Form

Welcome, New Clients!

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Thank you for considering Lowell Road Veterinary Center for your pet's needs. Please fill out our new client/patient registration form in entirety to ensure we can provide you and your pet with the best possible care.
Have you ever brought any pets to Lowell Road Veterinary Center before?(Required)
Reason for Visit to Lowell Road Veterinary Center:(Required)

Owner's Name(Required)
Address(Required)
Preferred Method of Contact(Required)
Spouse/Partner Name
Species(Required)

Sex(Required)
Spayed/Neutered?(Required)
Pet's Date of Birth(Required)
Please note: we require all records prior to first appointment
Max. file size: 15 MB.
Do you have Pet Insurance?(Required)
How did you hear about us?(Required)

Do we have permission to use photos of your pet(s) on social media, our website or in other marketing?(Required)
This field is for validation purposes and should be left unchanged.