Hours of Operation:
Mon - Fri: 8AM - 12PM, 1PM - 6PM, Sat: 8AM - 12PM, Sun: CLOSED
Dropoff Hours:
Mon - Fri: 7AM - 8AM

New Patient Form


Thank you for visiting our hospital. We look forward to getting to know you and your pet. Please help us to provide the best care possible for your pet by taking a moment to fill out this form.

Client / Owner Information
Spouse / Co-Owner Information
How did you hear about us?
Doctor Referral
If you have been referred to us by another veterinarian, please provide their information below.
Please tell us about your pet(s)
Please tell us about your pet(s)

To prevent the spread of infectious diseases and parasites, hospitalized and boarded animals must be current on all vaccines and free of internal and external parasites to enter our hospital for surgery, boarding, drop off or hospitalization.

I authorize Haines Road Animal Hospital to use my pet’s pictures on social media.

I authorize Haines Road Animal Hospital to release my pet’s records to other vets, boarding facilities, etc.

I hereby authorize the veterinarian 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 that these charges must be paid in full, at the time of release of the pet.