New Client Information Form

  • Please only fill out this form if you have a scheduled appointment with us. If you need to schedule a new client appointment please call, email or use the Contact us form. Thanks!

  • Payment is required at the time services are rendered


    Pet information (all pets within household)
  • Date Format: MM slash DD slash YYYY
    D/O/B
  • Date Format: MM slash DD slash YYYY
    D/O/B
  • Date Format: MM slash DD slash YYYY
    D/O/B
  • Date Format: MM slash DD slash YYYY
  • (We must have a copy of the previous vaccination history from a licensed Veterinarian) Each client is responsible for providing vaccination records either by fax or bringing a hard copy to RHAH upon pet drop off for boarding, grooming, etc.

    If records are not received vaccines will be given.

    BORDETELLA VACCINE IS REQUIRED AT RHAH EVERY 6 MONTHS.

  • The undersigned affirms the information provided above is correct and agrees to all conditions as stated in the above paragraph

  • Date Format: MM slash DD slash YYYY

******Please only fill out if you have an appointment, we ask you do not use this form to contact us about setting up an appointment. Please call, email, or use the Contact Us form. Thanks!********