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About Us
Services
More
- New Clients
- Client Forms
- Pharmacy
- Patient App
- Blog
- FAQs
- Careers

New Client Form

Los Feliz Small Animal Hospital is always happy to meet new pets and the people who love them. If you’re new to our practice, we welcome you! In an effort to provide your pet with veterinary care in a timely manner, we have made our Client/Patient Registration form available online.

Owner Name*

Street Address

Address line 1

Address line 2

City*

State / Province / Region

ZIP / Postal Code

Email*

Cell Phone*

Home Phone*

Work Phone

Do we have permission to text your cell phone number for appointment confirmation? *

HomeWorkCell

Primary Phone*

YesNo

May we text you information and pictures of your pet when they are in the hospital with us? *

YesNo

May we share your pet's picture and name on our website and Facebook page? *

YesNo

Co-Owner Name

Co-Owner Cell Phone Number

Co-Owner Work Phone Number

How did you find us?

Friend/FamilySaw Us From The StreetYelpGoogle "Map Search"Google Ratings/Google ReviewsGoogle Search EngineOther Website SearchAnimal Shelter VoucherLocal BusinessNextdoor AppFacebookInstagramCondo Association FlyerOther

Have you already made an appointment? *

YesNo

Pet's Name *

Pet's Species

CanineFelineOther

Pet's Sex

MaleMale-NeuteredFemaleFemale-SpayedUnknown

Pet's Breed

Mixed breed?

YesNo

Pet's Color

Markings

Approx. Age or Birthdate

Should we use caution when approaching? *

YesNo

Is your animal aggressive towards other animals? *

YesNo

Does your pet need a muzzle? *

YesNo

Is your pet currently on any medications? *

YesNo

Has your pet been microchipped? *

YesNoNot Sure

Additional Comments

Add a second pet?

YesNo

Is this your pet's first veterinary appointment? *

YesNo

What is the main health issue you would like to discuss with the doctor? *

Additional Comments

Thank you for choosing Los Feliz Small Animal Hospital. Our primary mission is to deliver the best and most comprehensive veterinary care available for your pet. An important part of our mission is making the cost of optimal care as easy and manageable for our clients as possible by offering several payment choices. Payment Options you can choose from are: Cash, Check, Visa, MasterCard, Discover, American Express, or CareCredit.

I understand that Los Feliz Small Animal Hospital requires payment in full at time of discharge. Healthcare plans and surgeries estimated over $500.00 will require a 50% deposit to begin pet's treatment. *

I have read and understand.

I understand that my account may be charged 15% interest on all outstanding balances older than 30 days and that if my account goes 90 days past due it will be turned over to a collection agency. All returned checks may be charged a $40 return check fee. *

I have read and understand.

I authorize the staff of Los Feliz Small Animal Hospital to provide treatment for my pets. *

I have read and understand.

Audio & Video Recording Policy
To promote the safety of employees, clients, guests and visitors, as well as the security of its facilities, our animal hospital reserves the right to conduct audio and video surveillance of any portion of its premises at any time. Video cameras will be positioned in appropriate places within and around company buildings and premises. Conversations in work areas and telephone conversations over business phones may be monitored or recorded as a part of normal business operations. Clients, visitors and guests understand that there is no expectation of privacy in connection with the use of this equipment or with the transmission, receipt, or storage of information in this equipment. The only exceptions to this policy include private areas of restrooms, showers and dressing rooms, and there will not be any audio or video recording in those areas.

I acknowledge receipt of a copy and consent to this animal hospital's policy on audio and video surveillance and expectations of privacy. I understand that by signing this acknowledgemen, I acknowledge and consent to the policy. *

I have read and understand.

Digital Signature (Name) *

Today's Date *

Pet's Name *

By submitting this form I have read and acknowledged the Privacy policy.

Thank you for submitting the New Client Form!

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Contact Info

3166 Los Feliz Blvd
Los Angeles, CA 90039
(323) 664-3309

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Looking for care closer to home? Visit other nearby locations within the Companion Pet Partners family.

Marina Veterinary Center , Westchester Veterinary Center

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