Veterinary Housecall Service
Hours of Operation
Monday - Friday:
8:00am - 6:30pm
Saturday: 
8:00am - 4:00pm

"Specializing in home veterinary care and offering a full service clinic."

Services : Forms : New Client

New Client Check In

If you would like to make an appointment and are a new client, please fill out the new client form prior to your scheduled appointment.

Thank you.

Form - New Client

Name & Email (required)
First Name (required)
Last Name (required)
Address (required)
Street Address (required)
City (required)
State/Province (required)
Zip/Postal Code (required)
,
Daytime Phone (required)
Phone TypePhone Number (required)
Evening Phone (required)
Phone TypePhone Number (required)
E-Mail Address :
Pet's Name (required)

Age: Years, Months

Type of Pet (required) :
Breed: (required)

Color

Microchip #

Sex: (required)
Male
Female

Neutered/Spayed
Neutered
Spayed

Pet's Name (#2)

Age: Years, Months

Type of Pet :
Breed

Color

Microchip #

Sex
Male
Female

Neutered/Spayed
Neutered
Spayed
Pet's Name (#3)

Age: Years, Months

Type of Pet :
Breed

Color

Microchip #

Sex
Male
Female

Neutered/Spayed
Neutered
Spayed

Are your pets vaccines current?
Do you have pets medical records?
Medical records at another veterinary Practice?
Yes
No

Name of Former Veterinary Practice

May we request a transfer of records?
Yes
No

Would you like us to call you for your appointment
Reasons or conditions that prompted your visit?

Allergies/Medical Conditions

Please Read
I understand, by indicating I agree and submitting this registration, that I am responsible for any charges incurred by my pet while in the care of the doctors at Veterinary Housecall Service and that charges are due and payable at the time of service, unless other arrangements are made in advance. Any balance that is carried over a period of 30 days will accrue a monthly finance charge of 2% or 20% per annum. Any balance that I leave unpaid will be forwarded to Veterinary Housecall Service's collection agency, and will incur a 25% collection fee for which I am liable, in addition to monthly finance charges.
I have read this statement and -
I Agree
I Disagree

Is this appointment for a housecall visit? (required)
Yes
No

Directions to home


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Veterinary Housecall Service
2100 Concord Blvd- Suite A
Crofton, MD 21114
(410) 923-0785
Fax  (410) 923-6377

info@vethousecallservice.com
Directions


 In emergency situations after hours, please contact Anne Arundel Emergency Veterinary Clinic,
(410) 224-0331.