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New Client Form

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 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.
  • Owner's Name

  • As a courtesy to our office (Reagor Pet Hospital) as well as to those patients who are waiting to schedule with our veterinarians, please give us at least 24 hours' notice if you plan to cancel your appointment. If you do not cancel or reschedule your appointment with at least 24 hours notice, your account will be assessed a $62 "no show" service charge. This fee will remain on your account and be payable before additional appointments can be scheduled.

    In addition: Please be aware that if you are more than 5 minutes late for your appointment we can consider this a missed appointment and you may need to reschedule in which case you would be assessed a "No show" fee.

    Please do your best to be at least 5 minutes early for your appointment to assure your pet can be seen.

    Please type your name in below to acknowledge this agreement and we do appreciate your understanding and continued loyalty.

  • Co-owner's Name & Contact #

  • Pet Information

  • Date Format: MM slash DD slash YYYY