Welcome new clients and patients!

We know your pet’s health is important and we thank you for trusting us to care for them.

To help us provide the best care possible, please take a few moments to fill out this form completely, and please bring it with you to your appointment. Thank you for your cooperation in letting us assist you.



New Patient Information Sheet

Which phone number do you prefer us to use?(Required)
Date Of Birth(Required)
Date of last Rabies vaccination
Please list names of any and all individuals allowed to make medical and financial decisions on your be-half: (must be over 18 years of age to accompany patient for visit without owner present)
I give permission(Required)
I understand(Required)
**We accept cash, Mastercard, Visa, Discover, American Express, and CareCredit. We do not accept checks.

Notice: We at West Hempstead Animal Hospital have a zero tolerance policy for any abuse of our staff, be it verbal or physical. Any actions on the part of a client that is deemed inappropriate may result in expulsion from our practice.