Fairview Veterinary Hospital

New Client - New Patient Inquiry

We are welcoming new clients and new patients to our practice during open office hours by appointment. Click here for the Regional Veterinary Dental Center new patient applicaiton

DO NOT use this application if your pet is ill or is having an emergency!

Complete and submit this inquiry to contact us regarding wellness care or elective procedures (for example: vaccine, spay, neuter, yearly wellness exam). You will be contacted within one business day by our Pet Concierge who will provide the estimates you may need, and will help you plan your pet’s first appointment.

At Fairview Veterinary Hospital our goal is to provide personal, convenient, affordable, and thorough pet care. Our entire team looks forward to meeting you and your pets!
 

What is your name?

First Name:

Last Name:

What is your pet’s name, breed, age?

Name:

Breed:

Age:

What is your pet’s gender?

 Female    Female (spayed)   Male    Male (neutered)

What type of pet do you have?

 Family Pet    Show Pet    Working Dog

Please fill out the following contact information:

Address 1:

Address 2:

City:

State:

Zip:

Phone:

Fax:

Email:

How were your referred to Fairview Veterinary Hospital?

 Phone Book    Friend    Self referred

Referrer’s Name:

What kind of wellness care does your pet need?
(be as specific as possible)

When did you first get your pet, and where is s/he from?

Please list all medications (including dosages), holistics, and
supplements that your pet is taking.

Does your pet have any other ongoing illnesses or health issues?

Is your pet allergic to any medications or anesthetics?

BestPetVet.com
7733 West Ridge Rd. (Rt. 20) Fairview, PA 16415
(814) 474-1504
Click here for driving directions
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