New Patient Form

Please complete our New Patient Form using one of the options below if your pet is a new patient at East Bay Veterinary Clinic.

Book An Appointment
Option 1

Complete Online

Fill out and submit the online form below.

Option 2

Print & Complete

Bring the completed form with you to our hospital.

Download Form

Option 3

Complete on Arrival

Complete the form when you get to our hospital, if you prefer.

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 East Bay Veterinary Clinic to release patient information to the primary care hospital or veterinarian.
By submitting this form, I hereby authorize East Bay Veterinary Clinic 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 East Bay Veterinary Clinic.

Caring for Pets in Oakland

East Bay Veterinary Clinic is accepting new patients! Get in touch today to book your pet's first appointment.

Contact Us

(510) 891-1514