 952-474-4194 … info@villageanimalhospital.org … …

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New Client Form

APPOINTMENT

Complete your new client form online!

Save time during your next visit by completing your new client form online before your first appointment. We look forward to seeing you soon!

Owner's Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Primary Phone *

Secondary Phone

Email *

Spouse/Co-Owner's Name

First

Last

Spouse/Co-Owner's Phone

Spouse/Co-Owner's Email

Pet's Name *

Species *

Dog
Cat

Breed *

Color

Sex *

Male
Male (neutered)
Female
Female (spayed)

Age/Date of Birth *

Add another pet? *

Yes
No

Pet's Name *

Species *

Dog
Cat

Breed *

Color

Sex *

Male
Male (neutered)
Female
Female (spayed)

Age/Date of Birth *

Add another pet? *

Yes
No

Pet's Name *

Species *

Dog
Cat

Breed *

Color

Sex *

Male
Male (neutered)
Female
Female (spayed)

Age/Date of Birth *

How did you hear about our clinic? *

Website/internet
Print ad
Location/sign
Breeder
Humane Society
Friend
Previously a client
Referral
Other

Whom may we thank for the referral? *

If other, please specify *

Previous Veterinary Clinic

Payment is expected at time of service or patient discharge.

Date *

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Thank you for making us the preferred veterinarian in Minnetonka, MN!

We’ve been serving the Lake Minnetonka area in veterinary medicine since 1968. These are just a few reasons you and your pet will love us! We look forward to partnering with you to ensure that your pet has a happy and healthy life.

How to contact us!

Contact us

Call: 952-474-4194

Email: info@villageanimalhospital.org

Fax: 952-474-3665

Address

17660 Highway 7

Minnetonka, MN 55345

Click here for directions.

Hospital Hours

Monday – Friday: 7:30am to 6pm

Saturday: 8am to 12pm

Sunday: Closed

Doctors Hours

Monday – Friday: 8am to 6pm

Saturday: 8am to 12pm

Appointments are requested.

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