Forms - Campbell River Veterinary Hospital

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 to be placed on our waiting list. (Please note that this does not mean that you will definitely get an appointment, or that you are considered an active client at our hospital, but we are trying our best to provide care to as many pets as we can.)

Our team will reach out to you as appointments become available. The required sections have an * asterisk.

CLIENT INFORMATION

Your Full Name *

Phone Number *

Address *

City *

Province *

Postal Code *

Email Address *

PET INFORMATION

Tell us about your pet(s) *

	Name	Species	Breed	Colour	Age	Sex
Pet #1
Pet #2
Pet #3
Pet #4
Pet #5

Name of previous veterinary hospital so we may obtain your pet's medical records *

How long have you lived in the Campbell River area? *

What veterinary service(s) do you require? (i.e. vaccines, spay/neuter, dental, medical, etc.) *

Additional Comments:

I understand that filling out this form DOES NOT guarantee that I will get an appointment. Our team will reach out to you when we are able to take you on as a client. *

Please verify that you are human *

I HAVE READ AND UNDERSTOOD THE PRIVACY POLICY *

New Client Registration - Waitlist

CLIENT INFORMATION

PET INFORMATION

Our Cookies

About Cookies

Cookie settings

Functional cookies

Analytics cookies

Marketing cookies