New Client Form

We’re so glad you’ve decided to join us! Please use the button below to get started.

New Client Form

Thank you so much for wanting to be a part of the Bayshore Animal Hospital family. We can’t wait for you to join us! Please ensure that the form below gets filled out as accurately as possible.

Name *

First

Last

Email *

Primary Phone *

Secondary Phone

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Who else is authorized to make decisions about your pet's healthcare? *

First

Last

Phone

How did you find out about our hospital? If you were referred by someone, who should we thank? *

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

What is the microchip number?

Payment is due in full at the time that services are performed. If your pet is being admitted into the hospital, we cannot begin the care of your Pet until you have confirmed your desire to do so by 1) signing the client consent & estimate form, and 2) leaving an initial deposit of 50% of the upper end of the estimate. This is the only way that we have of knowing for certain that you want us to proceed with the care of your Pet. We accept Cash, Visa, MasterCard, Discover, and CareCredit payments. We neither extend credit, nor bill for services. All open invoices are sent to collections after 45 days unless prior arrangements are made. *

I have read and accept the financial policy.

Appointment Date & Time *

Date

Time

Primary reason for appointment / concern (please be as detailed as possible) *

Everything was okay until: *

Patient's energy level

Normal
Increased
Decreased

Please list any medications or supplements you are giving your pet (name, dose, frequency, last given).

Name of heartworm and flea/tick prevention

Do you need refills of any of these medications?

If you need a medication refill, please list which medications.

Do you need refills on any prescription pet food?

If you need a prescription pet food refill, please let us know which kind.

What food does this pet normally eat?

Patient's appetite

Normal
Increased
Decreased

Are human foods given?

Drinking / water intake

Normal
Increased
Decreased

Urinary output volume

Increased
Decreased
No Change

Urinary output frequency

More
Less
No Change

Is the patient coughing?

If yes, for how long?

Is the patient vomiting?

If yes, for how long?

What is in the vomit? (Water, foam, digested food, etc.)

When was the last time this pet vomited?

Does your pet have normal stools?

Please describe. (Soft, diarrhea, watery, color, blood, mucus, etc.)

Body weight

Losing
Gaining
No Change
Unknown

Limping/lameness?

For how long?

Skin: itching/scratching?

Where?

Any fur loss? Skin bumps/rash? Dry scaling?

Respiratory (Select all that apply)

Coughing
Sneezing
Nasal Discharge
Eye Discharge

Has this pet recently traveled to the area?

When?

Has your pet recently been to a boarding or grooming facility?

Any behavior issues or concerns?

Any known allergies to vaccines/medications?

Please list allergies.

I am the owner/agent for described animal and authorize and request an exam for this pet. I understand the doctor will contact me after examining my pet to discuss recommended diagnostics and treatment and will have an initial estimate of charges. *

I have read and understand.

I understand payment is due when my pet is discharged, however, a deposit may be required after an estimate is prepared and discussed. I accept financial responsibility for all charges incurred for this pet. *

I have read and understand.

Signature *

Clear Signature

File Upload

Click or drag a file to this area to upload.

Schedule your appointment

We look forward to seeing you soon!

The doctors at Bayshore Animal Hospital are dedicated to strengthening the human-animal bond. As a team, we achieve our goals through honest caring while providing the best preventative and medical services for our client’s pets. We proudly serve the pets of Charlevoix-Petoskey and beyond.

Appointment

Have a question?

Get in touch! Complete our online form, and a member of our team will be in touch with you shortly.



Address

9400 US 31 North Charlevoix, MI 49720



Contact

Email: [email protected]
Phone: 231-547-4999
Text: 231-468-6781
Fax: 231-237-4005



Hours

Mon – Fri: 8:30 am – 5:00 pm
Sat & Sun: Closed

Name *

First

Last

Email *

Phone

How can we help you? *

Comment

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

In Case of Emergency

Please call 231-547-4999 in the event of an emergency, and our staff can triage your call right away! If you are in need of assistance after hours, you may be instructed to contact Bay Area Pet Hospital, a fully staffed 24-hour emergency pet hospital. You can call them at 231-922-0911 or visit their website by clicking here.