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Home > Contact Us > New Client Form

New Client Contact Form


sophie_at_river_1_1.jpgWelcome to The Vet Centre Richmond!
We are excited that you have chosen us to look after the well being of your pets.

When you come to our clinic, you can expect that we take your pets health as seriously as you do. We may ask you several questions regarding your pet's vaccination history, as well as any problems you have noted that you would like to discuss with the vet. In order to help our staff compile a comprehensive record for your pet, we ask that you either bring your pet's previous records with you to your appointment, or supply your previous vet's contact details so we can obtain your pets records ahead of time.

If you have any questions about our clinic, look around our website or feel free to contact us at the clinic to talk to one of our staff members.

 
Title*
First Name*
Last Name*
Address*
City*
Post Code
Home Phone*
Work Phone
Mobile Phone
Your Email Address*
How did your hear about The Vet Centre?
Your Pets Name
Pets Name*
Type of Pet
Dog
Cat
Bird
Rabbit
Type of Pet: Other
Date of Birth or Estimated Age*
Sex
Male
Female
De-sexed*
Yes
No
Breed*
Colour/ Markings*
Previous Veterinarian where records can be obtained if necessary
Date of last vaccination Date Selector
Please list any known illnesses or conditions
Is your pet on any medications?*
Yes
No
If yes, please list medication and dosages
Additional Pets Information
Pets Name
Type of Pet
Dog
Cat
Bird
Rabbit
Type of Pet: Other
Date of Birth or Estimated Age
Sex
Male
Female
De-sexed
Yes
No
Breed
Colour / Markings
Previous Veterinarian where records can be obtained if necessary
Date of last Vaccination Date Selector
Please list any know illness or conditions
Is your pet on any medication?
Yes
No
If yes, please list medication and dosage
 
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Cnr Gladstone Road & King Street
Richmond
Nelson
New Zealand
 
 
Ph: 03 544 5566 (24 hours)
Fx: 03 544 5561
 
Contact us