New Client / Patient Registration

Owner Information

Pet Information

Is your pet spayed or neutered?
Is your pet spayed or neutered?
Does your pet have any ongoing medical conditions, allergies or concerns?
Does your pet have any ongoing medical conditions, allergies or concerns?

Pet 2 Information

Is your second pet spayed or neutered?
Is your pet spayed or neutered?
Does your second pet have any ongoing medical conditions, allergies or concerns?
Does your pet have any ongoing medical conditions, allergies or concerns?
May we contact your previous vet to obtain your pet's medical history?
May we contact your previous vet to obtain your pet's medical history?
I understand that all fees are due at the time that services are rendered. Northshore Humane Society does not offer billing.
I understand that all fees are due at the time that services are rendered. Northshore Humane Society does not offer billing.
I understand that if I neglect to pick up my pet within 10 days of the pick up date, NHS assumes that the pet is abandoned and is hereby authorized to take possession of the pet and make any decisions as may be deemed best and necessary for its care.
I understand that if I neglect to pick up my pet within 10 days of the pick up date, NHS assumes that the pet is abandoned and is hereby authorized to take possession of the pet and make any decisions as may be deemed best and necessary for its care.
I give permission for my pet's photos and videos to be use on all forms of social media including Facebook, YouTube, and Twitter.
I give permission for my pet's photos and videos to be use on all forms of social media including Facebook, YouTube, and Twitter.

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

How did you hear about our vet clinic?

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.