Cornell University Hospital for Animals

 

For Clients


Client/Patient Registration

All fields with bold blue labels must be filled in.

Client Information
 
 

Owner's Name

Co-Owner's Name

Patient Information
(If multicolored, list predominant color first)
Veterinarian Information
I confirm the above information is accurate:
Owner must be 18 years of age or older

Please be sure that you have signed in your vehicle with the receptionist. If you have information from your regular veterinarian, please give that to the receptionist with this form.

New York State Law requires a valid rabies certificate to be presented upon arrival to our hospital. Failure to do so may result in your pet not being evaluated.

Payment is required at the time of service.


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