New Client/Client Update

Name: Lake Hills Veterinary Clinic
Address: 5298 Osage Beach Parkway, Osage Beach, MO, 65065, United States
Telephone: 573-302-8100
Price range: $

Thank you for choosing Lake Hills Veterinary Clinic as your choice! Please fill out the form as completely and accurately as possible.

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New Client/Client update

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit. If this is an emergency, or if your pet needs urgent care, please call us at 573-302-8100 for a faster response.

Owner Information

In order to expedite your first visit, please fill out this form completely and accurately so we can get to know you and your pet(s). Please have all of your pet's previous records emailed to [email protected] or faxed to 573-302-7142 prior to your appointment. If this is an emergency, or if your pet needs urgent care, please call us at 573-302-8100 for a faster response.

Owner Name *

First

Last

Spouse/Other

Home Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

Which phone numbers would you like to share with us? *

Cellular
Landline
Work
Spouse

Cellular *

Landline

Work

Spouse phone number

Email *

Employer

Spouse Employer

Pet Information

Pet's Name *

Species *

Canine
Feline

Breed

Color

Date of Birth/Age

Gender *

Male
Female

Spayed or Neutered? *

Any Known Allergies/Reactions? *

If Yes, please elaborate:

Is your pet’s Rabies vaccine up to date? *

When is the last time your pet was seen by a veterinarian? *

Who was your pet’s previous veterinary clinic? *

Would you like to add information for a second pet? *

Pet's Name *

Species *

Canine
Feline

Breed

Color

Date of Birth/Age

Gender *

Male
Female

Spayed or Neutered? *

Any Known Allergies/Reactions? *

If Yes, please elaborate:

Is your pet’s Rabies vaccine up to date? *

When is the last time your pet was seen by a veterinarian? *

Who was your pet’s previous veterinary clinic? *

Would you like to add information for a third pet? *

Pet's Name *

Species *

Canine
Feline

Breed

Color

Date of Birth/Age

Gender *

Male
Female

Spayed or Neutered? *

Any Known Allergies/Reactions? *

If Yes, please elaborate:

Is your pet’s Rabies vaccine up to date? *

When is the last time your pet was seen by a veterinarian? *

Who was your pet’s previous veterinary clinic? *

Whom may we thank for referring you to us? (check one)

Friend or Relative
Google Search
Facebook
Drove By
Staff Member
Shelter
Other

If they are clients at our hospital, whom may we thank?

Which staff member?

If Other, please elaborate how you found us

Credit Policy: We ask that all fees be paid at the time of service. We accept cash, personal checks (with identification), Visa, MasterCard, Discover, American Express, and CareCredit. *

I have read and understand

I give Lake Hills Veterinary Clinic authorization to access veterinary records from previous hospitals as needed. *

I have read and agree

Social Media/Photo Permission: Do we have your permission to post photos of your pet online? *

Please Sign *

Date *

Name

Request An Appointment!

We look forward to seeing you and your furry friend soon! Call us to schedule your next appointment or use our online form.

Appointment

Contact Us

Use the form below, and we’ll get back to you as quickly as possible. If you need immediate assistance during business hours, call us at 573-302-8100. We are available for emergency phone consultations after hours. You can also call the 24 hr ER hospital Horton Discovery at 573-777-3609.

Address

5298 Osage Beach Parkway
Osage Beach, MO 65065

Hours

Monday 8am-6pm

Tuesday-Friday 8am-5pm

Saturday 8am-1pm

We are available for emergencies after hours (Mon-Sun)

Contact

573-302-8100
[email protected]

Name *

First

Last

Email *

Phone

How can we help you? *

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