We offer same day sick appointments Monday through Friday. New clients save $40 off. Call our office at (757)340-3913 to schedule today!

Standard Registration Form

Welcome to our hospital and thank you for giving us the opportunity to care for your pet. We will provide the best care possible and be happy to answer any questions you have about your pet's health. In order to help us ensure your pet receives the best possible care, please take a moment to fill this online form out completely.

If you prefer, you can download our PDF form here, and print it out and fill it in to bring with you at your next appointment.

Bay Beach Veterinary Standard Registration Form

Owner's Name *

Spouse

Street Address *

Primary Contact Number *

Secondary Contact Number *

Email Address *

Confirm Email Address *

Emergency Contact Name and Phone Number *

(We do NOT give/sell your information. We will send you reminders via email.)

How did you hear about us? *

Employment

Company *

Address *

Supervisor *

Phone Number *

Email *

Confirm Email *

Pet Information

Reason for todays visit *

I hereby authorize the veterinarian to examine, prescribe for, or treat the above described pet. I assume responsibility for all charges incurred in the care of this animal. I understand that payments for these charges are due at the time of service. I also understand that I will be responsible for any and all fees associated with collection of this account.

Signature of Owner (entering your full name represents your signature) *

Date *

Please type the letters and numbers shown in the image.

Methods of payment accepted: Cash • Check • Mastercard • Visa • Discover • American Express • Care Credit