New Client Form

Welcome to Bethel Pet Hospital! Please complete this form before your pet's first visit. New patients receive their first exam FREE.

Client's Information

Full Name*

Phone Number*

Email*

Address*

City*

ZIP Code*

Patient's Information

Patient Name*

Species*

Breed*

Age*

Color*

Sex*

Spayed / Neutered*

How Did You Hear About Us?

Consent and Agreement

By signing this document, I certify that I am the owner or authorized agent of the pet listed above, am at least 18 years of age, and authorize Bethel Pet Hospital to examine, diagnose, and treat my pet. I understand that treatment recommendations and associated costs may change based on my pet's condition, and I authorize the hospital to discuss any additional diagnostics, medications, or procedures with me. I agree to pay for all services that I approve.

I have read and agree to the Consent and Agreement above.

Client Signature*

Sign here with your finger or mouse

Date*