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New Patient Form

We ask that all of our clients fill out our New Patient Form using one of the options listed below if their pet has not visited Banning Veterinary Hospital before.

Option 1

Complete Online

Complete and submit the online form below.

Option 2

Print & Complete

Bring the completed form with you to our hospital.

Download Form

Option 3

Complete on Arrival

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

New Patient Form

Owner Information

Emergency Contact

Patient Information

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 Banning Veterinary Hospital to release patient information to the primary care hospital or veterinarian.
By submitting this form, I hereby authorize Banning Veterinary 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 Banning Veterinary Hospital.

New Patients Welcome

Banning Veterinary Hospital is accepting new patients. Our experienced and compassionate vets care about the health of animals across Riverside County. Contact us today in order to book your first appointment.

Contact Us

(951) 849-3864