Chasing Tails New Client Form

Chasing Tails Mobile Veterinary Services

We are so glad you are here and honored to care for your pet! Please fill out as thorough as possible so we can provide you with the best possible care. All of this information has to be added to our software to get your appointment setup. Please note: We do have an active cancellation list that moves pretty quickly.
Bryan/College Station Pricing: Please Review Prior to Appointment Request. House Calls Start at $125.00 *Travel Fees May Apply*

Our Pricing for Bryan/College Station can be found here: https://chasingtailsvet.com/wp-content/uploads/2024/08/College-Station-Pricing-1.pdf
New Client/Patient Form
What type of appointment are you looking for?
Name

First NameLast Name
What is the best phone number to reach you at*
What is the best time to Call/Text?
Do you prefer we call or text you?

TextCall
Email address (please note: all lab results and vaccination records will be sent here):*
example@example.com
Address (please provide where appointment will take place)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What is the name of the Community or Apartment Complex you live in? (For Example: The Oaks of Timbergrove)
Is there a Gate Code (This information is kept confidential)?
If you live in an apartment/condo complex, please answering the following:
If the complex is greater than 4 stories, is there a lobby or central location we can meet you at? Please provide details of where to meet below:
Where is the best place to park? Please note our van is large and CANNOT fit into parking garages.*
If you will not be present at the appointment who will be at the appointment (& what is their relationship to you)?
Does this person have permission to make medical decisions and approve charges for your pet's care on your behalf?
Pet's name*
Please Select:*

DogCatExotic
Breed
Color*
Birthday or Estimated Age*
Please select:*

Female (Intact)Female (Spayed)Male (Intact)Male (Neutered)
Pet #2's name (optional, as needed)
Please Select:

DogCatExotic
Breed
Color
Birthday or Estimated Age
Please select:

Female (Intact)Female (Spayed)Male (Intact)Male (Neutered)
Pet #3's name (optional, as needed)
Please Select:

DogCatExotic
Breed
Color
Birthday or Estimated Age
Please select:

Female (Intact)Female (Spayed)Male (Intact)Male (Neutered)
Pet #4's name (optional, as needed)
Please Select:

DogCatExotic
Breed
Color
Birthday or Estimated Age
Please select:

Female (Intact)Female (Spayed)Male (Intact)Male (Neutered)
What are we seeing your pet(s) for? What concerns do you have? Please be as detailed as possible so we can come prepared to provide the best care.*
Is there someone we can reach out to for prior medical records (Please provide clinic names & phone numbers)?
How does your pet usually act at the veterinary office?
How does your pet usually act with visitors in their home?
Is your pet aggressive or fearful and will need a fear free appointment that is scheduled with additional time?*

YesNo
Is there anyone we can thank for your referral?
Is there any additional information you would like to provide?
We have a very active cancellation list, would you like to be added to this as well offered our first available slot?
If your pet(s) records are readily available they can be uploaded here:

Cancelof
We are so honored to care for your pet! Once your appointment is confirmed you will receive an email to sign the medical consent. Thank you so much!

Payment is due at the time services are rendered. We accept all major credit cards.
Should be Empty:

Chasing Tails Mobile Veterinary Services

Bryan/College Station Pricing: Please Review Prior to Appointment Request. House Calls Start at $125.00 *Travel Fees May Apply*

New Client/Patient Form

Bryan/College Station Pricing: Please Review Prior to Appointment Request. House Calls Start at $125.00 Travel Fees May Apply