New Client Form

Name: Somerset Animal Hospital
Address: 715 Rivard St., Somerset, WI, 54025, United States
Telephone: 715-247-2324
Price range: $

Thank you for choosing Somerset Animal Hospital! Please fill out the new client form below.

Get Started

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) information before your visit. Please note this form is not to be used for emergency appointments. If you have an emergency please call the Animal Emergency and Referral Center at 651-501-3766.

Owner/Primary Contact *

First

Last

Email *

Primary Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Who else is authorized to make decisions about your pet's healthcare? *

First

Last

Phone

How did you find out about our hospital? If you were referred by someone, who should we thank? *

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Please enter microchip number if known.

Where is your pet's most recent medical records and vaccination history? (Previous Veterinarian)

Phone number of previous veterinarian

Is there another previous veterinary clinic where your pet has records?

Do you have another pet you would like to add to this account?

Pet's Name

Species (dog, cat, etc.)

Breed

Age/Date of Birth

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Please enter microchip number if known.

Where is your pet's most recent medical records and vaccination history? (Previous Veterinarian)

Phone number of previous veterinarian

Name of previous veterinarian

Phone number of previous veterinarian

Is there another previous veterinary clinic where your pet has records?

Name of previous veterinarian

Phone number of previous veterinarian

Please upload your files below or call the clinic with your pet's most recent records and ask them to email the records to smallpets54025@gmail.com.

Upload Files

Click or drag files to this area to upload. You can upload up to 5 files.

Thank you for your interest in our clinic! We are excited to meet you and your pet! We just have one more question. Do you: *

Already have an appointment
Need an appointment and would like someone to call

Date of scheduled appointment *

Please note: New clients are required to make a deposit to schedule an appointment.

Phone

Request an Appointment

We're excited to meet you! Request an appointment online today.

Appointment

Contact Us

Let's Get In Touch

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Address

715 Rivard St.
Somerset, WI 54025

Contact

P: 715-247-2324
F: 715-706-6100
E: Smallpets54025@gmail.com

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Hours

Mon - Fri: 8:30AM-5:30PM

Sat & Sun: Closed

Name *

First

Last

Email *

Phone

How can we help you? *

Message