Name: Vet4HealthyPet Animal Hospital
Address: 434 S Tustin St, Orange, CA, 92866, US
Telephone: (714) 289-9400

Please fill out our New Patient Form using one of the options below if your pet is a new patient at Vet4HealthyPet Animal Hospital.

Book Online (714) 289-9400

Option 1

Complete Online

Complete and submit the online form below.

Option 2

Complete on Arrival

If you prefer, fill out the form when you get to our hospital.

New Patient Form

Owner Information

Owner First Name *

Owner Last Name *

Secondary Owner / Authorized Agent Name

Email *

Primary Phone *

Mobile Phone

Work Phone

Address *

City *

State *

Zip Code *

Employer *

Occupation *

Date of Birth *

How did you hear about us? *

Primary Care Veterinarian

Internet

Friend / Family

Community Event

Signage

Printed Publication

Radio

Other

Emergency Contact

Primary Emergency Contact Name *

Primary Emergency Contact Phone *

Secondary Emergency Contact Name

Secondary Emergency Contact Phone

Do you authorize your emergency contact(s) to make urgent treatment decisions if you are unreachable? *

Yes

Do you authorize your emergency contact(s) to receive patient information in addition to your primary care veterinarians? *

Yes

Patient Information

Pet Name *

Birth Date / Age *

Species *

Breed / Other Species *

Color

Vaccination Status *

Gender *

Spayed or Neutered? *

Presenting problem, special needs, concerns *

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 Vet4HealthyPet Animal Hospital to release patient information to the primary care hospital or veterinarian.

Primary Care Facility

Primary Care Veterinarian(s)

By submitting this form, I hereby authorize Vet4HealthyPet Animal Hospital 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 Vet4HealthyPet Animal Hospital.

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Patients

Patient Information
New Patient Form
Financing Options
Pet Care Tips

Emergencies

Happy Tails from Clients

The vet techs here are phenomenal! My little girl is shy and not very fond of the vet. The vet techs let her go at her own pace and have always won her over in the end. I really appreciate that. We recently had to move 30 minutes away and while this is still our preferred clinic for primary care, we recently had to take our dog to another clinic for emergency care and the Vet4HealthyPet team called me to get permission to share my dog's medical file with the emergency clinic. They are very considerate and I appreciate them reaching out to confirm with me first. I would absolutely recommend this practice!
- Jenny

New Patient Form

Option 1

Complete Online

Option 2

Complete on Arrival

New Patient Form

Owner Information

Emergency Contact

Patient Information

Primary Veterinarian Information

Now Welcoming New Patients

IMPORTANT NOTICE:Vet4HealthyPet is Temporarily Closed.

Dr. Yoo will be working from Yolinda Animal Hospital.

IMPORTANT NOTICE:
Vet4HealthyPet is Temporarily Closed.