New Client Information

Thank you for giving us this opportunity to care for your pet. Please help us meet your needs better by completing this information sheet. Please note that all professional fees are due at the time services are rendered.

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Welcome to Hickory!
Your Name (First and Last)
Spouse/Other (First and Last)
Address Line 1
Address Line 2
City, State, and Zip Code
Primary Telephone
Secondary Telephone
In case of emergency, please call...
How did you hear about us?your full name
Let's talk about your pet!
Pet #1 Name
Pet #2 Nameyour full name
Pet #1 Species (cat, dog, other)
Pet #2 Species (cat, dog, otheryour full name
Pet #1 Breed
Pet #2 Breedyour full name
Pet #1 Description (Color)
Pet #2 Descriptionyour full name
Pet #1 Age/ Birthday
Pet #2 Age/ Birthdayyour full name
If yes, please explain (If you have multiple pets be specific about which one)
Has your pet ever bitten anyone?
Are we going to be your pet's primary veterinarian?
Has your pet been seen previously by another facility?
Referring Veterinarians Nameyour full name
Referral Veterinarian Numberyour full name
Fileupload
Click Here to Upload Your Pets Records
Do we have permission to post pictures on our social media pages?

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. By writing your name below, you agree that in the event you cannot provide written proof of such vaccines, you authorize the doctor to provide vaccines and parasite control as needed for your pet.

Signatureyour full name
Dateyour full name
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Helping and healing for over 75 years.

Hickory Veterinary Hospital was founded in 1956 as a team of professionals committed to excellence in animal care. Our continued goal is to deliver the highest quality of veterinary medicine to our patients.