New Client Form

Primary Pet Owner's Information:

First name *

Last name *

Phone *

Street Address *

City *

Postal Code *

Is your mailing address different from your street address? *

Yes

Mailing Address *

City *

Postal Code *

Spouse/Co-Owner (if applicable)

Yes

First name - Spouse/Co-Owner *

Last name - Spouse/Co-Owner *

Phone - Spouse/Co-Owner *

Email - Spouse/Co-Owner

Street Address - Spouse/Co-Owner *

City - Spouse/Co-Owner *

Postal Code - Spouse/Co-Owner *

Is your mailing address different from your street address? - Spouse/Co-Owner *

Yes

Mailing Address - Spouse/Co-Owner *

City - Spouse/Co-Owner *

Postal Code - Spouse/Co-Owner *

Pet #1 Information:

Name *

Date of Birth *

Species *

Canine

Feline

Other

Other *

Breed *

Colour *

Sex *

Male

Female

Spayed or Neutered? *

Yes

Please select all the vaccines that your pet has received

Distemper, Parvo (Dogs only)

Bordetella/Kennel Cough (Dogs only)

CRP (Cats only)

Leukemia (Cats only)

Rabies (Both)

When is their next vaccination booster due?

Insurance provider and policy number (if applicable)

Please provide a brief summary of any previous or ongoing medical issues

Add information for a second pet:

Yes

Name *

Date of Birth *

Species *

Canine

Feline

Other

Other *

Breed *

Colour *

Sex *

Male

Female

Spayed or Neutered? *

Yes

Please select all the vaccines that your pet has received

Distemper, Parvo (Dogs only)

Bordetella/Kennel Cough (Dogs only)

CRP (Cats only)

Leukemia (Cats only)

Rabies (Both)

When is their next vaccination booster due?

Insurance provider and policy number (if applicable)

Please provide a brief summary of any previous or ongoing medical issues

Add information for a third pet:

Yes

Name *

Date of Birth *

Species *

Canine

Feline

Other

Other *

Breed *

Colour *

Sex *

Male

Female

Spayed or Neutered? *

Yes

Please select all the vaccines that your pet has received

Distemper, Parvo (Dogs only)

Bordetella/Kennel Cough (Dogs only)

CRP (Cats only)

Leukemia (Cats only)

Rabies (Both)

When is their next vaccination booster due?

Insurance provider and policy number (if applicable)

Please provide a brief summary of any previous or ongoing medical issues

Add information for a fourth pet:

Yes

Name *

Date of Birth *

Species *

Canine

Feline

Other

Other *

Breed *

Colour *

Sex *

Male

Female

Spayed or Neutered? *

Yes

Please select all the vaccines that your pet has received

Distemper, Parvo (Dogs only)

Bordetella/Kennel Cough (Dogs only)

CRP (Cats only)

Leukemia (Cats only)

Rabies (Both)

When is their next vaccination booster due?

Insurance provider and policy number (if applicable)

Please provide a brief summary of any previous or ongoing medical issues

Previous veterinary clinic information:

Name

Phone

Province

Please read the following Clinic Policies:

Clinic Code of Conduct Policy:

What you can expect from the WKAH Team:
All WKAH staff pride themselves in offering exceptional client and patient care ensuring our core values of Respect, Integrity, Supportive, Empathetic, Professional and Compassionate care are always paramount in all of our interactions
We believe it is our privilege to treat our clients’ pets and we will never take that for granted; treating your pets like we would our own and our pets are spoiled
We seek to continually provide a welcoming and comfortable environment which ensures trust and respect for all clients, visitors, staff, and volunteers
We treat everyone with dignity in a non-judgmental and respectful way whilst respecting diversity and equity of all staff and clients
Conduct ourselves ethically, with integrity and transparency in all interactions with clients and patients
Our staff shall not impose any personal beliefs or standards on clients
Protect and serve the public interest in pursuit of the highest medical and ethical standards of the Veterinary profession in British Columbia
Contribute to the education of our community in all matters relating to and promoting the health and safety of family pets

What WKAH expects from you as a Client:
Clients are expected to treat our employees, other clients and visitors with the utmost respect and dignity during all interactions; including conduct whether in person, by phone, in writing, or by voicemail
Always respect the professional opinion of your Doctor of Veterinary Medicine; even if you choose an alternative path for your pet
Refrain from any violent, abusive or harassing behaviour; including any discriminatory comments &/or actions against any individual or group of individuals &/or communities
WKAH reserves the right to exclude any person from accessing services as a consequence of violating this policy, up to and including discharged from the practice with no option of returning in the future

No-Show Policy:

If you don’t show up to a scheduled appointment, there will be a $25 fee applied to your account.

Clinic Capacity Management Policy:

Please review below how we prioritize patient needs on a day-to-day basis, which is always subject to change based on our overall DVM and RVT capacity (which can be impacted for various reasons, including extensive emergency events within the day and staff availability)

1st Priority: Emergencies
2nd Priority: Scheduled Surgeries
3rd Priority: Same Day Urgent Care Requests
4th Priority: Scheduled Routine Appointments

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Please be advised once we receive your request, we will target to respond within 3-5 business days