Galax Veterinary Clinic-New Client Registration Form

Thank you for considering our hospital as your pet’s provider of veterinary services. We are dedicated to maintaining the health of your pet and look forward to many future years together. Please complete this from as fully as possible prior to your first appointment which will help expedite the registration process and give us valuable insight in providing optimal care for your pet(s). You may submit a separate form for each pet or enter additional information as needed. The required sections have a red * asterisk.
  • Owner's Name

  • Co-owner's Name & Contact #

  • Address

  • Pet Information