Client Forms Lane Veterinary

Integrative New Client Form

Integrative New Client Form

Hello and welcome to Lane Veterinary! I am so excited you are interested in an integrative approach. I am here to support you and your beloved companion and cannot wait to learn more about your pet and meet you. - Dr. Lauren Beaird

Please be sure to send a complete medical history from your previous veterinarian(s) no less than 1 week prior to your visit. Records should include both general practice and specialty records, if applicable. They can be sent to pets@lanevet.com.

Collecting a patient history and understanding your goals and expectations for your pet's health during your first visit will take up a considerable amount of the 60 minute appointment. Take your time when filling out this form and submit at least one week prior to your visit (when applicable). Please consider spending 30 minutes (or more if needed) of focused time on this form. A thorough history will help us create an individualized plan for your pet before we meet. During the visit we will discuss this plan of action and adjust it to meet your expectation and individual goals.

Have you ever brought a pet to Lane Veterinary before?
Name
Name
First
Last
Address
Address
City
State/Province
Zip/Postal
Is There a Spouse/Partner/Family Member Who Should Be Listed On Your Account?

Section

Spouse/Partner/Family Member Name
Spouse/Partner/Family Member Name
First
Last
Is there anyone else (besides above listed contacts) who should be listed on your account, who has ongoing permission to make medical decisions for your pet(s)?

Section

Additional Account Name
Additional Account Name
First
Last
Emergency Contact Name
Emergency Contact Name
First
Last

Maximum file size: 52.43MB

Species
(please note, we are a canine and feline only clinic)
Is your pet microchipped?
Do you have more than one pet in your household?
Do You Already Have a Scheduled Appointment?
Appointment Time

General History