Patient Registration

Thank you for giving us the oppurtunity to care for your pet. We are committed to providing exceptional service to you while maintaining the highest standard of medical care for your pet. Please complete this registration form so we will have accurate information in your records to insure the best care possible.

    Client Information

    Patient information
    If you do not know if your pet has a microchip, or you do not know their chip ID number, please let us know at your appointment and we can check for you. 

    patients' medical history

    Please answer the following medical history questions to the best of your knowledge.
    Max file size: 20MB

    social media release

    We occasionally see photo worthy moments while your pet is in our clinic and would like to know if you are okay with us capturing and posting those moments/pictures on our Social Media venues.
    I, the undersigned, do hereby grant permission to Logue's TLC Pet Hospital to post my pets' photo(s) or other items, hereinafter referred to as "Materials", on their TLC Pet Hospital faceook page, website, printed materials, and/or other social media venues.
    I hereby release you and your employees from all claims and demands arising out of or in connection with any use of said "Materials", including, without limitation, all claims for invasion of privacy, infringement of my right of publicity, defamation and any other personal and/or property rights.
    I acknowledge and agree that no sums whatsoever will be due to me as a result of the use of the "Materials" ar any rights therein for Logue's TLC Pet Hospital newsletters or publications.

Thank you!

Please make sure you have also completed the Client Registration.