New Client Form

We’re happy to welcome you and your pet to Dodgeville Veterinary Services! To help us prepare for your first visit and provide the best care possible, please complete the New Client Form below. Filling it out ahead of time allows us to create your pet’s record, review medical history, and streamline your check-in process.

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New Client Information Form

Complete the New Client Form

Name *

First

Last

Secondary Name

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Referred By

Pet Information

Pet's Name *

Species (dog, cat, etc.) *

Age *

Breed *

Gender *

Male
Neutered Male
Female
Spayed Female

Color *

Privacy & Permissions

Your privacy is very important to us. We assure you that your personal information will be kept secure and used only for veterinary care purposes.

Permission for Photos and Social Media Use *

I DO give Dodgeville Veterinary Services permission to photograph me and/or my pets for use in print or electronic media, including social media and marketing materials.
I DO NOT give Dodgeville Veterinary Services permission to photograph me and/or my pets for use in print or electronic media, including social media and marketing materials.

If there are any previous medical records please have those emailed to dvs@dodgevillevet.net prior to your visit, so we can have complete records on your pet. Thank you!

Payment & Communication Authorization

I understand and agree to pay Dodgeville Veterinary Services at the time services are rendered for all pets I bring in. Acceptable payment methods include cash, credit card, check, CareCredit, Tuapay, and Scratchpay.

In the event of default, I understand that I will be responsible for any reasonable attorney or collection fees necessary to recover the outstanding balance owed to Dodgeville Veterinary Services.

I authorize Dodgeville Veterinary Services to contact me via my current and any future phone numbers, email addresses, or wireless devices regarding my account. I also consent to being contacted through automated calls or messages for account-related communication. I understand I may withdraw this consent in writing at any time.

By signing below, I confirm that I have read this disclosure and agree to the terms stated above. *

Clear Signature

Today's Date *

Message

New Client Form

New Client Information Form

Complete the New Client Form

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Location

Contact Information

Hours

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