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New Client Application Form

Please fill the form out completely and one of our Team Members will get back to you.
  • Owner Information

  • Your primary email for the doctor to send your pet's report and discharge instructions
  • Secondary Owner

  • Previous Medical Information

  • Please upload any medical records or vaccine history that you have for your pet here.
    Drop files here or
  • What is the first appointment type you need to schedule for your friend? (Check all that apply)
  • Cat Information

  • Please send us a favourite picture of your cat(s):
    Drop files here or
  • Tell us about your cat; How & when did they come into your life? What are their favourite treats, games & resting places? Do they go outdoors at all?
  • Coverdale Cats Veterinary Clinic we recommend regular examinations, vaccinations, commercially prepared balanced pet foods, parasite prevention and regular dental hygiene procedures to ensure your pet receives the very best care. Please select one of the following options.
  • Coverdale Cats likes to use images of our client’s pets to demonstrate the care and attention that they receive here. When pets are happy and calm during treatment and care, it helps other pet owners to see how enjoyable veterinary care can be. Coverdale Cats will never share images of pets during the last moments of their lives, and we use discretion in the images taken and shared. We only use pet names and not owner names in our content. By signing below, I hereby give Coverdale Cats the right to use the name, video, and photographs of any of my pets in connection with its website and any promotional materials in any and all media, including, but not limited to, printed material, internet, social media, and film for display, public relations, and marketing. I hereby acknowledge receipt of adequate consideration and waive the right (i) to charge or be compensated for the use of the pictures, and my pet(s)’s name(s), and (ii) to inspect or approve the images prior to any form of usage. I understand that the images may be modified to use as design elements.
  • Date Format: MM slash DD slash YYYY