New Patients

Welcome to Paws of Pleasanton!

Complete your new client paperwork online!

Before your first appointment, please complete the form below. If you have any questions, please don’t hesitate to contact us directly at 925-380-1888. We look forward to seeing you soon!

Your appointment time is reserved especially for you and your pet. Please try to arrive on time. If you choose to cancel with less than 12 hours notice or if you miss your appointment, we reserve the right to charge you an examination fee.

We appreciate your understanding and thank you for helping us ensure other sick pets can be seen when you’re unable to make your appointment.

CLIENT INFORMATION

Name *

First

Last

Spouse/Partner Name

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Occupation/Employer

Spouse Occupation/Employer

Owner's Date of Birth *

Home Phone

Mobile Phone *

Work Phone

Spouse Phone

Email *

Spouse Email

Preferred Method of Contact *

Home Phone
Mobile Phone
Text
Email

Select one or more options.

How did you hear about us? *

Google
Facebook
Instagram
Drive By
Client Referral
Other

Who can we thank for referring you? *

PET INFORMATION

Patient Name *

Species (cat/dog/other) *

Breed *

Gender *

Male
Female

Color *

Spayed/Neutered *

Age (months or years) *

Add another pet? *

Patient Name *

Species (cat/dog/other) *

Breed *

Gender *

Male
Female

Color *

Spayed/Neutered *

Age (months or years) *

Add another pet? *

Patient Name *

Species (cat/dog/other) *

Breed *

Gender *

Male
Female

Color *

Spayed/Neutered *

Age (months or years) *

Add another pet? *

Patient Name *

Species (cat/dog/other) *

Breed *

Gender *

Male
Female

Color *

Spayed/Neutered *

Age (months or years) *

Add another pet? *

Patient Name *

Species (cat/dog/other) *

Breed *

Gender *

Male
Female

Color *

Spayed/Neutered *

Age (months or years) *

Add another pet? *

Patient Name *

Species (cat/dog/other) *

Breed *

Gender *

Male
Female

Color *

Spayed/Neutered *

Age (months or years) *

Do we have your permission to share your pet's image and story on our website, social media, and other forms of media? *

Who should we contact for previous records for your pet?

I hereby authorize the veterinarian to examine, prescribe for, or treat the above described pet. I assume responsibility for all chanrges incurred in the care of this animal. I understand that payment is DUE IN FULL at time of service. A deposit of 50% of the treatment plan may be required before treatments or hospitalization of your pet. I recognize that financial concerns should be discussed PRIOR to examination and treatment. *

I have read and understand.

Digital Signature *

Clear Signature

Date *

SCRIBBLEVET CONSENT AND RELEASE

Our veterinary services utilize ScribbleVet, a tool from Kairo Care, Inc., which records your pet's appointments for improved clinical documentation.We need your consent to proceed with the recording. By signing this agreement:

Appointment Recording: You agree that your vet appointments may be recorded. If you don'twant to be recorded, let us know.
Usage Rights: You grant us permission to share these recordings, and any other materials you choose to provide, for the purpose of improved clinical documentation.
Age Confirmation & Understanding: You affirm that you are at least eighteen years old, and that you understand and accept the terms in this agreement.

We are committed to providing the best care for your pet in a manner comfortable for both of you.

Client's Name: *

Client's Signature: *

Clear Signature

Date: *

Name

Family-owned and operated veterinary care in Pleasanton, CA

Compassionate care for your four-legged family members.

At Paws of Pleasanton Animal Hospital, we know your pets are family. We strive to treat each and every patient who walks through our doors with kindness and respect. We offer cutting-edge medical technology to keep your pets feeling their best! We're also a proud member of the Pleasanton Chamber of Commerce.