New Client Registration

Welcome to Companion Animal Clinic! Please share more information about you and your pet below.

New Client Registration Form

Please complete this form 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). The required sections have a red * asterisk.

Pet Owner

First Name*

Last Name*

Email Address*

Confirm Email*

Daytime Phone*

Home Phone

Employer

Work Phone

If different from Daytime Phone

Secondary Contact

Mailing Address

Pet Information

Additional Information

Who should we thank for referring you to us?

If you indicated that you were referred by a customer and we would love to thank them!

Terms & Conditions

I assume responsibility for all charges incurred in the care of this animal. I also understand these charges will be paid at the time of service or release and that deposit may be required for surgical treatment.*

I agree to the Terms & Conditions

If you are human, leave this field blank.

If you would prefer to talk with one of our team members, see our contact info for our phone number, hours, and directions.

Contact Information

Manage Your Pet's Care From Your Phone

Message Our Team Directly, View Vaccine Records, Refill Prescriptions, and Schedule Appointments!

Sign Up or Sign In Online

Get the App for iOS

Get the Android App

Pet Food Delivered Directly to Your Door!

Companion Animal Clinic provides the convenience of pet food delivered directly to your home with Purina® Pro Plan®Vet Direct. Get scheduling, pricing, and registration details!