(704) 563-5858
info@hickorygroveanimalhospital.com

Home
About Us
- Our Team
Services
Resources
New Clients
Contact
Book Appointment

Home
About Us
- Our Team
Services
Resources
New Clients
Contact
Book Appointment

Home
About Us
- Our Team
Services
Resources
New Clients
Contact
Book Appointment

New Client Form

Name: Hickory Grove Animal Hospital
Price range: $

Welcome to Hickory Grove Animal Hospital. We invite you to complete our new patient form online to ensure your first visit is as smooth and efficient as possible.

Get Started

Why Do We Request This Form?

We ask new clients to complete the new patient form to ensure their visit is as efficient and thorough as possible. By providing detailed information about your pet in advance, we can focus more on their care during the appointment and less on paperwork. This form allows us to review your pet’s medical history ahead of time, helping us identify any preventative care that may be due or other important health concerns. With this information, we can prepare to deliver personalized, comprehensive care tailored to their unique needs.

Name *

First

Last

Email *

Primary Phone *

Secondary Phone

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Who else is authorized to make decisions about your pet's healthcare? *

First

Last

Phone

How did you find out about our hospital? If you were referred by someone, who should we thank? *

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Color *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

What is the microchip number?

Do you have a second pet? *

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Color *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

What is the microchip number?

Do you have a third pet? *

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Color *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

What is the microchip number?

Do you have a fourth pet? *

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Color *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

What is the microchip number?

Do you have a fifth pet? *

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Color *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

What is the microchip number?

Reason for request (update vaccines or sick appt.) *

Has your pet been to the vet before and if so what is the name of the previous clinic they have been to? *

Payment is required at the time services are rendered at Hickory Grove Animal Hospital. Accepted payment methods include cash, debit cards, credit cards (Visa, Mastercard, American Express, Discover), and CareCredit. Please note that all cards must be signed by the card owner, and billing options are not available. *

I have read and accept the financial policy.

Comment

Schedule an Appointment

Hickory Grove Animal Hospital proudly serves pets in Charlotte, including Hickory Grove, Windsor Park, Shannon Park, Plaza Midwood, and nearby areas. We are accepting new clients and invite you to schedule your pet’s visit through our convenient online booking system.

Book Appointment

Have a Question?

Please complete our online form and a member of our team will get back to you as quickly as possible.

Name *

First

Last

Email *

Phone

How can we help you? *

Phone



Location

5450 N Sharon Amity Rd
Charlotte, NC 28215



Contact Information

(704) 563-5858
info@hickorygroveanimalhospital.com



Hours

Mon – Fri: 7:30 AM – 6:00 PM
Sat: 1st, 3rd, & 5th of every month 8 AM – 2 PM
Sun: Closed