New Client and
Patient Form
Slider
Please fill out the new client and patient form.

CLIENT INFORMATION

Client Yellow Pages Internet Search Engine Website Drove by and Saw Sign Yelp Facebook

PATIENT INFORMATION

Yes No

MEDICAL HISTORY

Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
I am financially responsible for the patient described about and agree to pay all the fees incurred. I understand that any medical or surgical procedure is attended by risk, and that it is not possible to guarantee the successful outcome of any such procedure. This agreement is in force indefinitely from this date unless I notify the Clinic in writing to the contrary.

BURIEN VETERINARY HOSPITAL

At Burien Veterinary Hospital, we serve pets and their guardians in Burien, White Center, Tukwila, Des Moines and the surrounding areas.
Phone
(206) 242-1290

VISIT US

Location
14628 Ambaum Blvd SW, Seattle, WA 98166
Hours
Monday - Friday : 9am - 6pm
Saturday : 9am - 12pm
Sunday : Closed

LOCAL RESCUES

Image
Image
Image

HOSPITAL AFFILIATIONS

Image
© 2018 Burien Veterinary Hospital | Veterinary Marketing & Websites by VetMarketingPro.