New Client Form Treating Your Pet Like Family Since 2004

New Client Form

Thank You For Choosing High Point Veterinary Hospital

If you are scheduled for your first appointment with us, please fill out the form below and we will be in contact with you shortly!

First Name
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Last Name
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Phone
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Email
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Street Address
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City
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State
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Zip Code
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Emergency Contact Name
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Emergency ContactPhone
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Date
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Pet's Name
Please enter your pet's name.
Species
Please enter your pet's species.
Breed
Please enter your pet's breed.
Age
Please enter your pet's age.
Previous Veterinarian
Please enter your previous veterinarian.
Is your pet male or female?
Please indicate whether your pet is male or female.
Is your pet neutered/spayed?
Please indicate whether your pet is neutered/spayed.
How did you learn about our hospital? Local shelter/rescue, Facebook, Online search, Referral, Drove by, Other
Please enter a message.

If you were referred by someone let us know who it is so we can make sure to thank them. (Please include first and last name)

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“I had a very sick kitten and I could not have found a better veterinarian!! The whole office was great and very kind and understanding about my situation! I would recommend this veterinary hospital to anyone with a pet!”
- Carrie W.
“Wonderful vet. Very well run organization”
- Cecil S.
“Wonderful customer service, best pet assistance I ever had, super compatible service fees. strongly recommend.”
- Valentina G.