New Client Form

If you are visiting us for the first time and would like to complete your details before you arrive, simply complete this form. If you haven’t made your first appointment yet, click here for our contact details.

Thank you for entrusting your loved one in our care.

Title

Name

Partner Name (if applicable)

Address

Suburb

Postcode

Mobile

Home / Work Phone

Email Address

How did you hear about us?

Or (tick multiple if applicable)

Name

Pet Instagram Handle (If applicable)

Breed

Date of Birth/Age

Sex

Desexed

Colour

Microchip Number

Pet Insurance Provider & Policy No

Date and location of last vaccination?

Current medication

Previous medical history request

Name

Breed

Date of Birth/Age

Sex

Desexed?

Colour

Microchip number

Pet Insurance Provider & Policy No

Date and location of last vaccination?

Current medication

Previous medical history request

Comments

Date & Time of Appointment

I hereby authorise the Veterinarians of Port Adelaide Veterinary Clinic to examine, prescribe for, or treat, the above described pet(s). I assume responsibility for all charges incurred in the care of this animal. I also understand these charges will be paid at the end of consultation or the times of discharge and that a deposit may be required for surgical or complex medical cases. I understand that photos may be taken of my pet that may be used on our clinic social media sites, and that I must notify staff if I do not wish for this to occur.

Ready to book an appointment?

At Port Adelaide Veterinary Clinic, your pet’s health and well-being are our top priority.
Book your pet’s next appointment online or give our friendly team a call to find out how we can support their ongoing care.