New Client Form

Thank you for choosing Baxter Veterinary Clinic for your pet's healthcare needs. We want to provide your pet with the best care available in an environment that they will love to visit! We'd like to learn a little more about your pet before the appointment to better meet these goals. Completing this form online will also save you time on the day of the appointment! Multiple pets? Please fill out the form completely for the first pet. For additional pets, you only need to complete your name and the patient information sections for each new form. Please call us at 803-547-8387 if you have any questions!

*Keep in mind if your pet is having a medical issue, please call us instead of filling out this form! It can take up to 48 hours for us to receive the form via e-mail.*

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Address 2

Phone Number

Area CodePhone Number

Phone Number

Area CodePhone Number

Spouse/Other Responsible Individual

First NameLast Name

Spouse/Other Phone Number

Area CodePhone Number

E-mail

Please tell us how you found us, or who we can thank for your referral:

Please tell us some information about your pet/our new patient

Pet's Name

Gender

MaleFemale

Spayed/Neutered?

SpayedNeuteredNone of the above

Birthday/Age

Breed

Color/Markings

***If you have a copy of your pet's medical record, please bring it with you***

Any prior or current issues with your pet's health?

Any prior surgeries?

Special diet?

Current Medications:

Allergies? (vaccines, environmental, medications)

Contact information/name for previous Veterinarian:

Name of Boarder/groomer/other caregivers we should know about:

Please list additional pets in household including species