Skip to content

New Patient Form

If you are bringing your pet in to Affordable Pet Vet Clinic for their first appointment with our Tracy vets please fill out our New Patient Form using one of the options below.

Book An Appointment

Option 1

Complete Online

Complete the form below and submit it online before arriving at our hospital.

Option 2

Print & Complete

Download the form and bring the completed form with you to our hospital.

Download Form

Option 3

Complete on Arrival

If you prefer, you can fill out the form when you arrive at our hospital.

Option 1

Complete Online

Complete the form below and submit it online before arriving at our hospital.

Option 2

Complete on Arrival

If you prefer, you can fill out the form when you arrive at our hospital.

New Patient Form

Owner Information

Emergency Contact

Patient Information

Primary Veterinarian Information

By listing your primary care veterinarian above, you are authorizing Affordable Pet Vet Clinic to release patient information to the primary care hospital or
veterinarian.
By submitting this form, I hereby authorize Affordable Pet Vet Clinic to render medical care for my pet(s) as deemed necessary by the veterinarian. I understand that no guarantee can be given to the outcome of treatments and take it as my responsibility to comprehend any risks involved. I agree to pay for the cost of all services to which I consent to by written or verbal estimate. I understand that a deposit is required before diagnostics and treatments can be initiated and that payment in full is required prior to discharge of patient from Affordable Pet Vet Clinic.

Looking for quality veterinary care for your pet in Tracy?

(209) 832-8882