Existing Client New Pet Form

Please complete one form for each pet.
* Your privacy is important to us. All information you provide is considered confidential.

Owner Information

Owner Name *

First

Last

Co-Owner Name

First

Last

Owner's Email *

Pet Information

(If you have additional pets, please complete this information for each pet)

Pet's Name

Age / Date of Birth

Species:

Dog
Cat
Other (Specify Below)

Sex

Male
Male (neutered)
Female
Female (spayed)

Breed

Color

Should we obtain veterinary records from another veterinary hospital? *

Yes
No

If your pet has had vaccines within the last three years, please list them below and provide the place they received them.

Please list any ongoing health issues your pet has:

Please list any medication and dose your pet is currently on:

Please state the primary reason for your pet’s appointment. *

PAYMENT FOR SERVICES

El Gato Veterinary Hospital does not bill. We require payment in full at the time services are rendered. We accept, Visa, Mastercard, Discover, American Express, cash, CareCredit. In the case of a pet emergency, we require a deposit at the time of admission and the additional payment at the time of discharge. *

I have read, understand, and agree to these conditions.

Signature *

Clear Signature

Comment

Address

El Gato Veterinary Hospital
15748 Los Gatos Blvd.
Los Gatos, CA 95032

Numbers

Call or Text: 408-356-2181
Fax: 408-356-5790

For 24 hour emergency services, please visit MedVet Campbel (408) 371-6252.

Temporary Hours of Operation

M-F: 9:00 am - 5:00 pm
Saturday: Closed
Sunday: Closed

Even though we’re located in Los Gatos, CA, we’re happy to provide veterinary care to pets in Campbell, San Jose, Santa Clara, Sunnyvale, Mountain View, Morgan Hill, Boulder Creek, Felton, Cupertino, Monte Sereno, Saratoga, and Scotts Valley! Looking for the best veterinary care in Northern California? Come see the team at El Gato Veterinary Hospital.