New Clients - Lakeview Animal Clinic

We can’t wait to meet your pets!

Lakeview Animal Clinic is accepting new clients on a limited basis at this time. If you would like contacted directly please fill out the form below, adding as many pets as you’d like seen here at the clinic. This account is NOT consistently monitored so if you do not receive a call within 48hrs please call the office directly.

For more immediate scheduling call us directly at (724) 537-5881 or stop by to get started!

**Please Call the office at 724-537-5881 for any time-sensitive or emergency issues**

New Client Form

Owner Information

Contact Information

Name (First and Last) *

Email *

Street Address *

City *

State *

Zip *

Home Phone Number *

Work Phone Number

Cell Phone Number

Additional Information

Co-owner (Spouse) Name

Co-owner (Spouse) Cell Number

How did you find out about our practice?

If other, how did you find us?

If personal referral, who? We would like to thank them.

Pet Information

Tell Us About Your Pet

Name

Species

Breed (if known)

Color

Date of birth or age

Sex

Identification (Tattoo or Microchip #)

Medical History

Any current medications or supplements?

Up-to-date on vaccinations? (DHLPP and Rabies)

Any previous health concerns or chronic disease?

Any allergies or drug reactions?

Any other relevant information that you would like our doctors to be aware of?

Pet Pet

If you are human, leave this field blank.