Client Registration | George Town

Client Registration Form

Welcome!

Thank you for giving us the opportunity to care for your pet.

Please do not complete this form until AFTER you have scheduled an appointment with us.

Call us at (345) 640-5838 to schedule an appointment.

Once an appointment has been made, please take the time to fill in this form completely.

By completing this form, I am authorizing Kman Vets to assess my pet. I am aware that treatment and medications are in addition to the consultation fee, and will have the opportunity to review a treatment plan and estimated cost for additional services.

Please submit one form PER pet

For multiple pets, please complete the first form entirely, then for subsequent pets enter your first and last name and the pet information.

Primary Contact

Cell Number

Home Phone

Email Address

Spouse/ Other Contact

Spouse/ Other Phone

Spouse/ Other Email

Your Address

Apartment/ Flat info (if applicable)

PO Box Number

KY Postal Code

Sub-District/ Division

District

Island

Your Pet's Name

Pet Date of Birth

Is your pet Male or Female?

Has your pet been Spayed/ Neutered?

Species

Breed

Colour/ Markings

Does your pet have a microchip?

Environment

Is your pet on Heartworm prevention?

Is your pet on flea and tick prevention?

Previous Veterinary Care/ Adoption History

Previous or Current Medical diagnoses/ Allergies or Concerns

KMAN VETS

Where Compassion Meets Excellence

Client Registration Form