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New Patient Form

Please complete the New Patient Form using one of the methods below if your pet is a new patient at Animal Emergency Clinic of San Diego.

Option 1

Complete Online

Fill out and submit the online form below.

Option 2

Print & Complete

Bring the finished form with you to our hospital.

Download Form

Option 3

Complete on Arrival

If you rather, fill out the form when you get to our hospital.

New Patient Form

Owner Information

Emergency Contact

Patient Information

Primary Veterinarian Information

Please fill this section in if we are not your primary care veterinary hospital. By listing your primary care veterinarian, you are authorizing Animal Emergency Clinic of San Diego to release patient information to the primary care hospital or veterinarian.
By submitting this form, I hereby authorize Animal Emergency Clinic of San Diego to render medical care for my pet(s) as deemed necessary by the veterinarian. I understand that no guarantee can be given to the outcome of treatments and take it as my responsibility to comprehend any risks involved. I agree to pay for the cost of all services to which I consent to by written or verbal estimate. I understand that a deposit is required before diagnostics and treatments can be initiated and that payment in full is required prior to discharge of patient from Animal Emergency Clinic of San Diego.

Experienced Emergency Vet Care in Poway

Animal Emergency Clinic of San Diego is a family-run after-hours and critical care hospital, providing veterinary emergency care since 1985. If your pet is experiencing an emergency, contact us to get the help your pet needs.

Contact Us

Contact (858) 748-7387