New Client Form Caring for your pets since 1962.

Thank you for choosing Conchester Animal Hospital!

If you are a new client, please fill out the form below prior to your first visit.

First Name
Please enter your first name.
Last Name
Please enter your last name.
Phone
Please enter your phone number.

This isn't a valid phone number.
Email
Please enter your email address.

This isn't a valid email address.
Street Address
Please enter your street address.
City
Please enter your city.
State
Please enter your state.
Zip Code
Please enter your zip code.
Emergency Contact Name
Please enter your emergency contact.
Emergency ContactPhone
Please enter your emergency contact phone.

This isn't a valid phone number.
Date
Please enter the date.
Pet's Name
Please enter your pet's name.
Species
Please enter your pet's species.
Breed
Please enter your pet's breed.
Age
Please enter your pet's age.
Previous Veterinarian
Please enter your previous veterinarian.
Is your pet male or female?
Please indicate whether your pet is male or female.
Is your pet neutered/spayed?
Please indicate whether your pet is neutered/spayed.
How did you learn about our hospital? Local shelter/rescue, Facebook, Online search, Referral, Drove by, Other
Please enter a message.

If you were referred by someone let us know who it is so we can make sure to thank them. (Please include first and last name)

“The staff at Conchester Animal Hospital are fantastic. Our senior dog has been in their care for almost 2 weeks. The care, love and compassion they showed was heart warming and helped him to recover.”
- Sarah M.
“Always receptive to questions & goes out of their way to help. If you love your animal, go there. All my dogs & granddoggies have gone to Dr. Lombardo & the entire group for many years.”
- Margie V.
“I called for my new puppy. They were able to see us that day. Everyone at the vet office was so nice to us and Zeus. Dr. Trey explained everything to us and didn't do unnecessary tests. They were all warm and caring people.”
- Averi D.

Our team completes continuous education courses to deliver the latest top-quality care.
Proud to consistently earn top Google ratings and reviews for service, care, and value.
Concerned with costs? We’re proud to offer CareCredit. Just ask!
We Provide Top-Notch Excellent Medical Care
Our Staff is Extremely Caring & Supportive
We Have Served Our Community Since 1962

Does Your Pet Need Something?

Book An appointment

Stay Informed & Up-to-Date

more blogs