New Pet Registration for Current Clients

If you are a current client at Bothell Pet Hospital and you’ve brought home a new pet, we would love to meet the newest addition to your family and welcome them to our practice! Please fill out the form below to get started. (If you are a new client to Bothell Pet Hospital, please visit our Welcome & Registration page.)

New Patient Intake Form

Confirm Pet Owner Information

Address
City
State/Province
Zip/Postal
Preferred Method of Contact

Tell Us about Your New Pet(s)

Is your pet traveling from out of state? (If so, it is very important that we receive updated information on their movements.)
DOG VACCINATION INFORMATION
CAT VACCINATION INFORMATION
Allergies *
Chronic Conditions *
Medications/Supplements *
Special Diet *
 

If you have another new pet to add, please click the "Add" button below.

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Professional Fees Are to Be Paid at the Time Services Are Provided

In admitting my pet(s) for diagnostics, treatment, or surgery, I authorize the veterinarians of Bothell Pet Hospital and their support staff to administer such treatment and/or perform such diagnostic or surgical treatment as deemed necessary. It is understood that I may request an estimate of charges for any services. No guarantee or assurance can be made as to the results that may be obtained. Furthermore, I realize that these charges may exceed a given estimate if complications arise. I understand that I will be contacted prior to treatment, if possible, should complications arise. I assume financial responsibility for all charges incurred for services provided and understand that full payment is required upon request.

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