Skip to content
Online Refill Request
GET DIRECTIONS
4500 NE Cornell Road, Hillsboro, OR 97124
503-648-1643
About
Our Team
AAHA Accredited
Cat Friendly Practice
FAQs
New Clients
Our Patients
Services
Emergency Care
Preventive Care
Urgent & Illness Care
Cat Boarding
Online Store
Testimonials
Pet Health
Blog
New Kitten Resources
New Puppy Resources
Online Library
Pet Insurance
Community
Cat Adoptions
Fundraisers
Pet Pictures with Santa
Supplies & Medical Donations
Blog
Make An Appointment
Contact Us
Forms
Careers
Home
»
New Client Form
New Client Form
Name
(Required)
First
Last
Additional Owner/Contact Person
First
Last
Address
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Primary Contact Number
(Required)
Other Phone
Email
(Required)
Our Practice Management Software can only accept one email address, so please give us only the best email address to reach you.
Your Employment
Work Phone
May we call you at work if necessary?
Yes
No
Co-Owner's Employment
Work Phone
May we call you at work if necessary?
Yes
No
**We respect your privacy. Your email will be used only to contact you regarding your pets. It will not be sold or distributed. You will receive an email with login instructions for Pet Portals, our free online service allowing you to check your pet’s reminders and request refills or appointments.
(Required)
I have read and understand
How did you hear about our hospital? Please be as specific as possible. For client referrals, whom may we thank?
We'd love to make your pet a star on our social media! We share cute photos with your pet’s first name only.
(Required)
I approve Frontier Veterinary Hospital to share photos/videos of my pet
I decline sharing photos/videos
All professional fees are due at the time services are rendered. We will gladly prepare a cost estimate upon request (please ask the doctor or receptionist). Methods of payment include: Cash, Visa, MasterCard, American Express, Discover, Money Order, and Care Credit. As owner or agent for the pet(s) described on the following page, I certify that I have read and agree to the above financial policy, and that I am at least 18 years of age. I assume financial responsibility for all services rendered, and I understand that any accounts over 30 days past due will be subject to a monthly interest fee.
(Required)
I have read and understand
Signature
(Required)
DateToday's Date
(Required)
MM slash DD slash YYYY
Please introduce us to your pet(s)!
Pet's Name
(Required)
Date of birth or age? Is this actual or estimated?
(Required)
Species
Dog
Cat
Other
Breed
(Required)
Color
(Required)
Male or female?
(Required)
Male
Female
Is this pet spayed or neutered?
(Required)
Yes
No
Previous Veterinarian/Veterinary Hospital
(Required)
Any prior illnesses or surgeries we should know about?
(Required)
Any allergies we should know about?
(Required)
Additional Pet, if applicable.
Pet's Name
Date of birth or age? Is this actual or estimated?
Species
Dog
Cat
Other
Breed
Color
Male or female?
Male
Female
Is this pet spayed or neutered?
Yes
No
Previous Veterinarian/Veterinary Hospital
Any prior illnesses or surgeries we should know about?
Any allergies we should know about?
Signature
(Required)
Reset signature
Signature locked. Reset to sign again
Make Appointment
Find Us
Services
Our Team
What's Next
1
Call us or schedule an appointment online.
2
Meet with a doctor for an initial exam.
3
Put a plan together for your pet.
Make An Appointment
