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PET OF THE MONTH

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Arely is a magical wire-hair fox terrier. The terrier breed originated in England, so Arely has an Old English name which means courageous...
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Client Registration

Thank you for giving us the opportunity to care for your pet. So that we may better serve you, please complete the following online form. Otherwise, please download and complete the Client Registration Form and bring it with you to your appointment. We look forward to meeting you and your pet!

OWNER INFORMATION     (*Required Field)  
Name * :
 
Spouse Name :
 
Address * :
 
City/State/Zip * :
 
Home Phone :
 
Cell Phone :
 
Secondary Cell Phone :
 
E-Mail * :
 
Employer :
 
Employer
Phone Number :
 
Other Employer :
 
Other Employer
Phone Number :
 
Who may we thank
for referring us to you :
 






AGENT INFORMATION
 
* Other than you and any additional owner(s) listed above, are there any other persons to whom you give primary responsibility for the care of your pet?
 
* Please indicate if you would like to receive updates via text message. If yes, please indicate on which cell phone you would like to receive these reminders:
 

Emergency Contact :
 
Emergency Phone :
 

Please list any special directions for our veterinarians/staff
in the event we are unable to contact you, your co-owner,
or authorized agents for consent in an emergency:

 


Professional fees are due at the time services are provided.

We accept the following credit cards for your convenience:
Visa, MasterCard and Discover.

We offer Care Credit services for those wishing to apply.


Pewaukee Veterinary Service is pleased to provide the following services:

General Health & Wellness Care • Injury & Illness • Sedation & General
Dentistry • Orthopedics • Laparoscopic Surgery • Endoscopy • Ultrasound
Digital Radiology • Diagnostics & Laboratory • Rehabilitation • Acupuncture
Dog Day Care • Grooming • Boarding Services • Retail

We are proud members of:
American Animal Hospital Association
American Veterinary Medical Association
Wisconsin Veterinary Medical Association
American Board of Veterinary Practitioners


N29 W23950 Schuett Drive, Pewaukee, WI
Phone: 262-347-0787 • Fax: 262-347-0780
©2013 Pewaukee Veterinary Service