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Home
About
- Our Team
- Reviews
- Careers
- Contact
Services
Resources
Book Appointment

Aloha Animal Medical Center

New Client
Form

Save time during your next appointment! Please complete your required new client form online from any device at any time before your first visit.

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Online Forms

New Client Form

Thank you for the opportunity to care for your pet. Please provide as much information as possible on this new client form, including your pet’s health history. Please note we do require a deposit for all new clients to hold an appointment. Someone from our client services team will call you to collect the deposit and schedule your pet’s appointment.
We look forward to seeing you soon!

Primary Owner *

First

Last

Co-Owner/Spouse

First

Last

Email *

Primary Phone *

Secondary Phone

Work Phone

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Employer *

Emergency Contact Name *

First

Last

Phone *

How did you hear about us? *

Google
Website
Walk/Drive By
Internet Search
Other

If you were referred by someone, who should we thank?

Pet Health History

Number of Pets *

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Color *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Reason for Visit? *

Pet's current medications *

Pet's current diet *

Authorization

I hereby authorize the veterinarian to examine, prescribe for, or treat the above described pet. I assume responsibility for all charges incurred in the care of this animal. I also understand that these charges will be paid at the time of release and that a deposit may be required for surgical treatment. *

I have read and accept the financial policy.

Methods of Payment accepted: Cash, VISA, Mastercard, American Express, Discover card and CareCredit.

Signature

Clear Signature

Date

Website

Ready to visit us?

Exceptional Pet Care in Aloha!

Contact our animal hospital in Aloha, Oregon, to introduce your pet to some new and loving veterinary friends. We proudly serve the pets of Beaverton, Hazeldale, Tigard, Cedar Hills, Hillsboro, Tulation, Portland, Sherwood, and surrounding communities.

Book Appointment

Have a Question?

Complete our online form, and a member of our team will be in touch with you shortly.



Address

17455 SW Farmington Road Suite 29A Aloha, OR 97007



Contact

E: [email protected]
Phone: 503-591-8625
Fax: 503-649-0478



Hours

Monday – Friday: 8:30am – 6:00pm
Sat-Sun: Closed

Name *

First

Last

Email *

Phone

How can we help you? *

Phone

Aloha Animal Medical Center

New ClientForm

Online Forms

New Client Form

Pet Health History

Authorization

New Client
Form