New Patient Form

Please fill out the following form before your first appointment with us.

New Patient Form

Thank you for choosing Green Oaks North Pet Hospital. In order to better serve your pet, please fill out the following form as thoroughly as possible. If you have any questions, please give us a call.

- Step 1 of 3

Owner's 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

Place of Employment

How did you become aware of our clinic? *

Yellow Pages
Location
Humane Society North TX
Yelp
Previous Client
Internet
Personal Referral
Other

If previous client, what is their name (so we know who to thank)? *

If personal refferal, what is their name (so we know who to thank)? *

If other, please list *

Pet Information

Pet's Name *

Species

Breed *

Color *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Previous Clinic (Name & Location)

Please list the last date your dog received the following: Rabies vaccine, Distemper vaccine, Parvo vaccine, Bordetella vaccine, Lyme vaccine, Lepto vaccine, Fecal test, Heartworm test. *

Please list the last date your cat received the following: Rabies vaccine, Distemper vaccine, Leukemia vaccine, Fecal test, Leukemia/FIV test, Dental cleaning. *

Reason for visit *

Describe any chronic problems (kidney disease, heart condition, diabetes, etc.: *

Do you have another pet to add? *

Second Pet Information

Pet's Name *

Species

Breed *

Color *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Previous Clinic (Name & Location)

Please list the last date your dog received the following: Rabies vaccine, Distemper vaccine, Parvo vaccine, Bordetella vaccine, Lyme vaccine, Lepto vaccine, Fecal test, Heartworm test. *

Please list the last date your cat received the following: Rabies vaccine, Distemper vaccine, Leukemia vaccine, Fecal test, Leukemia/FIV test, Dental cleaning. *

Reason for visit *

Describe any chronic problems (kidney disease, heart condition, diabetes, etc.: *

Authorization and Payment

All Fees Are Due Upon Release Of Patient *

Cash
Credit Card
Check
CareCredit

*A 15% monthly fee will be added to all unpaid balances.*

GONPH may use my and my pet's name and likeness to promote GONPH and/or their activities *

I give consent
I do not give consent

GONPH may fax my pet's records to another clinic in the event of doctor referral, moving etc. *

I agree
I do not agree

Client Signature *

Date *

Download Our App!

The VitusVet app makes caring for your pet easier with quick access to medical records, appointment requests, refill requests, and more.

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Ready for a visit?

We proudly serve the pets of Arlington, Grand Prairie, Euless, Viridian, and the surrounding areas. We look forward to seeing you and your pet! You may request an appointment by clicking the button below.

Request appointment

We offer virtual care!

Address your pet’s health from the comfort of your home by quickly connecting with your veterinarian. Click here to download the Anipanion App from your app store.

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Find Us

1890 NE Green Oaks Blvd
Arlington, TX 76006

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Our Hours

Mon–Fri: 7:30 am to 7:00 pm
Sat: 8:00 am to 12:00 pm
Sun: Closed

Hours may vary on holidays

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Contact Us

817-860-3087 (phone)
817-860-3088 (fax)
technician@greenoaksnorthvets.com

Have a question?

Get in touch! Complete our online form, and a member of our team will be in touch with you shortly.

Name *

First

Last

Email *

Phone

How can we help you? *