412-361-5OOO Contact us
New Client Form

We Our
FurryFriends

If you are a new client or have a new patient with us at East End Veterinary Medical Centre please give us a call to schedule your appointment at (412)361-5000. We will have you fill out our Client Information Form upon arrival. In the interest of saving time, we have made this form available to you online. Please feel free to fill out the form prior to your arrival, and either print it out to give to us, or send it to us at info@eevmc.com. DOWNLOAD NEW CLIENT FORM
Please give us a call to schedule your appointment at (412)361-5000

 

    Best Way to reach you?

    Pet Information

    Sex:
    Age:
    Species:
    If Cat:
    Number of Pets in Household?
    Is your pets previous health record availale?

    Statement of Ownership and Consent: I am the owner and/or agent for the above animal and have the
    authorization to consent to treatment if and when it is necessary. I also assume financial
    responsibility for all charges incurred, and agree to pay all such charges at the time services are
    rendered or as arranged prior to examination and/or treatment. SIGNATURE ( typing in your name acts as
    your signature )

    © 2023 East End Veterinary