Skip to Main Content
Ask About Financing

New Patient Form

We want to help make your first visit to Pine Grove Animal Clinic as relaxed and easy as possible. If your pet is new to our veterinary clinic, please take a couple of minutes to complete our New Patient Form online before your appointment, or arrive 10 minutes early to complete the form at our office.

Option 1

Complete Online

Complete and submit the online form below.

Option 2

Complete on Arrival

If you prefer, fill out the form when you arrive.

New Patient Form

Owner Information

Emergency Contact

Patient Information

Primary Veterinarian Information

Please fill this section in if we are not your primary care veterinary hospital. By listing your primary care veterinarian, you are authorizing Pine Grove Animal Clinic to release patient information to the primary care hospital or veterinarian.
By submitting this form, I hereby authorize Pine Grove Animal Clinic to render medical care for my pet(s) as deemed necessary by the veterinarian. I understand that no guarantee can be given to the outcome of treatments and take it as my responsibility to comprehend any risks involved. I agree to pay for the cost of all services to which I consent to by written or verbal estimate. I understand that a deposit is required before diagnostics and treatments can be initiated and that payment in full is required prior to discharge of patient from Pine Grove Animal Clinic.

New Patients Welcome

Pine Grove Animal Clinic is accepting new patients! Our experienced vets are passionate about the health of companion animals. Get in touch today to book your pet's first appointment.

Contact Us

(570) 345-0880