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Download Our App|(253) 927-4546

Services
Hours & Location
About Us
Contact

Download Our App
(253) 927-4546

Services
Hours & Location
About Us
Contact

New Client Form

Co-Owner Name (first & last):

Co-Owner Phone Number:

General Information

Previous Veterinarian and Phone Number

How did you hear about us?

Phone Book

Drive-By

Client Referral

Other

If you were referred by a client, what is their name?

I understand that my pet’s picture may be used on social media sites.

YES, you can use my pet's photo on social media.

NO, do not use my pet's photo on social media.

Patient Information:

Pet's Name

Age / DOB

Species

Breed

Color

Sex

Female Intact

Female Spayed

Male Intact

Male Neutered

Canine Vaccines & Dates

D/H/P
Lyme
Coronavirus
Bordetella
Leptospirosis
Parvo Virus
Rabies

Feline Vaccines & Dates

Distemper
Calici
Chlamydia
Rhinotracheitis
Rabies
Feline Leukemia Virus
Feline Infectious Virus

Payment is due when services are rendered. Acceptable means of payment include cash, check, MasterCard, Visa and Discover. In the event your account is referred to an attorney for collection of any amount you owe, then you will be responsible for all expenses of collection, including reasonable attorney’s fees and costs.*

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Edgewood Veterinary Clinic

900 Meridian Ave E Suite 1
Milton, WA 98354

phone: (253) 927-4546
fax: (253) 927-6902 • email us

Proudly serving the Milton, WA area, including (but not limited to): Milton, Auburn, Fife, Federal Way, and Puyallup.

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