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New Client FormLake Area Animal Clinic

Save time during your next appointment! Complete your required forms online from any device at any time before your visit.

New Client Form

Client Information:

Name *

First

Last

Email *

Home Phone *

Work Phone

Driver's License Number: *

MUST SHOW PROOF OF A VALID DRIVER'S LICENSE UPON ARRIVAL

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Is your residential address the same as your mailing address? *

Yes
No

Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

How will you be paying your bill today? *

Cash
Check
Visa
Mastercard
Discover

I hear by authorize the veterinarian to examine, prescribe for, or treat my pet. I assume responsibility for all charges incurred in the care of the animal. I also understand that all professional FEES ARE DUE AT THE TIME
SERVICES are rendered.

Signature *

Signature of responsible party

Date *

Pet Health History: Pet # 1

Pet Name *

Birth Date or Age *

Sex *

Female
Female Spayed
Male
Male Neutered

Breed

Color

Current Medications your pet is taking

Prior Illnesses/Surgeries

Primary reason for visit

Did you adopt this pet from the Hill Country Human Society? *

Yes
No

Add an additonal pet information? *

Yes
No

Pet Health History: Pet # 2

Pet Name *

Birth Date or Age *

Sex *

Female
Female Spayed
Male
Male Neutered

Breed

Color

Current Medications your pet is taking

Prior Illnesses/Surgeries

Primary reason for visit

Did you adopt this pet from the Hill Country Human Society? *

Yes
No

Add an additonal pet information? *

Yes
No

Pet Health History: Pet # 3

Pet Name *

Birth Date or Age *

Sex *

Female
Female Spayed
Male
Male Neutered

Breed

Color

Current Medications your pet is taking

Prior Illnesses/Surgeries

Primary reason for visit

Did you adopt this pet from the Hill Country Human Society? *

Yes
No

Add an additonal pet information? *

Yes
No

Pet Health History: Pet # 4

Pet Name *

Birth Date or Age *

Sex *

Female
Female Spayed
Male
Male Neutered

Breed

Color

Current Medications your pet is taking

Prior Illnesses/Surgeries

Primary reason for visit

Did you adopt this pet from the Hill Country Human Society? *

Yes
No

Ready to visit?

We proudly serve the pets of Burnet, Llano, Kingsland, Marble Falls, and surrounding areas. We look forward to seeing you and your pet. Easily book an appointment for your pet by clicking the button below!

Book Appointment

Have a question?

Get in touch! You can call us with any questions you may have, and a team member will happily answer them.

Address

15560 E St Hwy 29 Buchanan Dam, TX 78609

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Contact

Text: 512-793-6191

Call: 512-793-6191

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Hours

Monday – Friday: 8am to 5pm
(Closed on Tuesday 12:30pm to 1:30pm)
Saturday and Sundays: Closed

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