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Home
About Us
Meet Our Team
Hospital Tour
Job Opportunities
Blog
How Did We Do?
FAQs
Pet Owners
New Client Form
Payment Options
Pet Education
Pet Insurance
Services
General Services
Cat and Dog Vaccination
Spay and Neuter
Dog Teeth Cleaning
Laser Therapy for Pets
Emergency Care
Domestic Health Certificate
H5N1 Alert
Contact
Rate Us!
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New Client Form
Owner Information
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Last
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Phone (Primary)
(Required)
Email (Primary)
(Required)
Phone (Secondary)
Email (Secondary)
How did you hear about us?
(Required)
Google
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Promotional Event
Walk in
Hyde Park Street Fair 2022
Edge Brewery Ad
Live in the Neighborhood
Other
Pet Information
Pet's Name
(Required)
DOB / Age
(Required)
Species
(Required)
-
Dog
Cat
Sex
(Required)
-
Male
Male Neutered
Female
Female Spayed
Breed
(Required)
Color
(Required)
Please list any allergies, medication and/or previous health concerns.
(Required)
Pet Medical History
Previous Veterinary Practice (if any)
Previous Veterinarian (if any)
Date of last vaccine (if known)
MM slash DD slash YYYY
Is your pet on any medication or supplement?
Yes
No
If yes, please list the medication or supplement:
What food does your pet eat?
Does your pet have allergies or drug reactions?
Yes
No
If yes, please list the allergies and reactions:
Are there any current or past medical conditions of which we should be aware?
Yes
No
If yes, please comment on the conditions(s) and indicate if they are current or past conditions:
Please use the following box to provide us with any other relevant information about your pet:
Add 2nd pet?
Yes
No
2nd Pet Information
Pet's Name
DOB / Age
Species
-
Dog
Cat
Sex
-
Male
Male Neutered
Female
Female Spayed
Breed
Color
Please list any allergies, medication and/or previous health concerns.
2nd Pet Medical History
Previous Veterinary Practice (if any)
Previous Veterinarian (if any)
Date of last vaccine (if known)
MM slash DD slash YYYY
Is your pet on any medication or supplement?
Yes
No
If yes, please list the medication or supplement:
What food does your pet eat?
Does your pet have allergies or drug reactions?
Yes
No
If yes, please list the allergies and reactions:
Are there any current or past medical conditions of which we should be aware?
Yes
No
If yes, please comment on the conditions(s) and indicate if they are current or past conditions:
Please use the following box to provide us with any other relevant information about your pet:
Add 3rd pet?
Yes
No
3rd Pet Information
Pet's Name
DOB / Age
Species
-
Dog
Cat
Sex
-
Male
Male Neutered
Female
Female Spayed
Breed
Color
Please list any allergies, medication and/or previous health concerns.
3rd Pet Medical History
Previous Veterinary Practice (if any)
Previous Veterinarian (if any)
Date of last vaccine (if known)
MM slash DD slash YYYY
Is your pet on any medication or supplement?
Yes
No
If yes, please list the medication or supplement:
What food does your pet eat?
Does your pet have allergies or drug reactions?
Yes
No
If yes, please list the allergies and reactions:
Are there any current or past medical conditions of which we should be aware?
Yes
No
If yes, please comment on the conditions(s) and indicate if they are current or past conditions:
Please use the following box to provide us with any other relevant information about your pet:
Vaccination and Medical Record Release Form & Social Media Consent
The Idaho Veterinary Medical Board requires written consent for your pet's medical records and/or vaccination history to be released to Hidden Springs Animal Hospital and for HSAH to release the same to any veterinarian, such as a specialist, you may visit at a later time.
(Required)
HSAH has my permission to obtain/release my pet’s records.
HSAH does not have my permission obtain/release my pet’s records.
Hidden Springs Animal Hospital would like your permission to be able to post pictures of my pet(s) on their social media profile(s).
(Required)
HSAH has my permission to post pictures of my pet on social media.
HSAH does not have my permission to post pictures of my pet on social media.
Pet Owner's Signature
(Required)
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