Registration Form

Registration Form

Please fill out this form if you are a new client and/or new patient visiting White Haven Veterinary Hospital for the first time.

    Pet History

    By signing below, I give the Veterinarian at White Haven Veterinary Hospital authorization to treat my pet. I understand I am responsible for payment in full at the end of my visit. I also understand that by signing below, I authorize WHITE HAVEN VETERINARY HOSPITAL to disclose the above-named animal’s medical records to be used by other emergency or referral veterinary practices, groomers, animal shelters or boarding kennels.