New Canine/Feline New Pet Form Congratulations on your new pet. Please fill in the information so that we can add your pet to our system and create their patient file. Please contact our office at (610) 367-4744 if you have any questions. Pet's Name* First Last Sex* Male Female Male Neutered Female Spayed Unknown Birthday or Approximate Age*Species* Canine Feline Avian Ferret Mouse/Rat/Rodent Reptile/Amphibian Rabbit Gerbil/Guine Pig/Hampster Breed*Color*Please list any allergies that you pet has:What diet are you currently feeding your pet?Where did you obtain this pet?* Friend Breeder Pet Shop Humane Society Other Photo Authorization Form* Yes, I authorize Gilbertsville Veterinary Hospital to take and use photos of my pet. I understand that these photos may be used on social media platforms, hospital marketing materials and the Gilbertsville Veterinary Hospital website. No, I do not authorize Gilbertsville Veterinary Hospital to take or use photos of my pet. If your pet has a microchip or permanent identification please type their ID for our records.Please list any alerts that our team should be aware of (examples: needs a muzzle, does not like cats, does not like dogs, etc.)Has your pet had any prior illness or surgical procedures in the past? Please describe below.Is your pet currently taking any medication?Reason for your pet's visit? Please describe below.Please list any questions or concerns that you have for our veterinarians or team members.I am the said owner or the agent for the above described pet and have the authority to execute this consent. I understand that I will be responsible for the cost of veterinary services, prescriptions, and product at the time they are rendered for my pet. I have read and understand this authorization and consent by typing my name below.* First Last Submit a Comment Cancel reply You must be logged in to post a comment.