New Client/Patient Form

Save time during your next appointment! Complete your required forms online from any device at any time before your visit.

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New Client/Patient Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit. If this is an emergency, or if your pet needs urgent care, please call us at 806-792-8387 for a faster response.

Name *

First

Last

Email *

Primary Phone *

Secondary Phone

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Preferred Method of Contact *

Email
Phone
Postal Mail

Spouse/Co-Owner Name

First

Last

Spouse/Co-Owner Phone

How did you find out about our hospital? If you were referred by someone, who should we thank? *

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Age/Date of Birth *

Color *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Previous veterinarian information:

I give permission for Veterinary Clinic of Lubbock to share photographs or case specific information about my pet in all media (including promotion, advertising, sale, publicizing, and general marketing of Veterinary Clinic of Lubbock). *

Signature *

Date *

Website

We Treat Your Pets Like Family

We proudly serve the pets of Lubbock as well as from surrounding areas.

It is our mission to partner with our clients to nurture and preserve the human-animal bond by providing compassionate, expert, and affordable veterinary care from your pet’s first adventure throughout a long and healthy life.

Contact Us

Have a Question?

Use our online form and we’ll get back to you as quickly as possible. If you need immediate assistance, you can reach us during business hours at (806) 792-8387.

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Email Address

[email protected]

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Call Us

(806) 792-8387

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Visit Us

2314 50th St. Lubbock, TX 79412

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Hours

Monday – Friday: 8:30 am – 5:30 pm
Saturday – Sunday: Closed

Name *

First

Last

Email *

Phone

How can we help you? *

Name