New Client 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.

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Welcome to Platte Lake Veterinary Clinic

9671 Honor Hwy, Honor, MI 49640
Phone: (231)-325-2528

OWNER'S INFORMATION

Date *

OWNER'S NAME (S) *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

CELL PHONE *

OK TO COMMUNICATE BY TEXT? *

HOME PHONE

WORK PHONE

EMPLOYER

EMERGENCY NAME

EMERGENCY PHONE NUMBER

EMAIL ADDRESS *

WE DO NOT SHARE ANY OF OUR CLIENT'S INFORMATION

HOW DID YOU HEAR ABOUT US?

If a current client referred you, you both get a credit!!

PET INFORMATION

PET'S NAME *

Checkboxes *

DOG
CAT
OTHERS

SEX *

MALE
FEMALE

SPAYED/NEUTERED? *

AGE *

DATE OF BIRTH *

Breed *

Color: *

Website

New Client Form

Welcome to Platte Lake Veterinary Clinic

OWNER'S INFORMATION

WE DO NOT SHARE ANY OF OUR CLIENT'S INFORMATION

If a current client referred you, you both get a credit!!

PET INFORMATION

Ready for a visit?

Location

Contact

Hours

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