New Client Info

Taconic Veterinary Center offers our new patient form online so you can complete them in the convenience of your own home or office. Simply fill out the form below, and we will receive your submission electronically.

New Client Info

Client Information

Were you referred by a family member or friend?

Pet Information

Number of Pets *

Pet 1

Dog/Cat *
Male/Female *
Spayed/Neutered? *

Pet 2

Dog/Cat *
Male/Female *
Spayed/Neutered? *

Pet 3

Dog/Cat *
Male/Female *
Spayed/Neutered? *

Pet 4

Dog/Cat *
Male/Female *
Spayed/Neutered? *

Current Veterinarian

Would you like us to contact a previous vet for records for your pet?

Acknowledgment and Signature

I authorize Taconic 24/7 Veterinary Center, to release information including diagnosis, records, lab work and x-rays of my above named pet(s). This release of information will remain in effect until terminated by me in writing. This information may be released to:
I understand that payment is expected at the time services are rendered. I hereby authorize the staff of Taconic Veterinary Center to render any treatment which is deemed necessary to the health of my pet(s) while in custody of the hospital. I understand that in the event of any unusual or emergency circumstances, the staff will make every attempt to contact me or my designated representatives before, if time permits, proceeding with the treatment. I understand that I will be financially responsible for all emergency procedures including the Estimate of Charges provided to me in person or over the telephone. I understand that a deposit is required for all pets admitted to the hospital. I understand that if my account is not kept in good standing, a finance fee of $25 will be added to the account and it will be forwarded to a third-party collections agency, which may affect my credit rating. I understand that photos/videos may be taken of my pet for training or marketing purposes. *

Get the best care for your best friend.

Walk-in or request an appointment online